World journal of clinical pediatrics最新文献

{"title":"Prevalence of obesity, determinants, and its association with hyperglycaemia among community dwelling older adolescents in India.","authors":"Vansh Maheshwari, Saurav Basu","doi":"10.5409/wjcp.v13.i4.91638","DOIUrl":"10.5409/wjcp.v13.i4.91638","url":null,"abstract":"<p><strong>Background: </strong>Globally, obesity and diabetes mellitus (DM) are emergent public health concerns in the adolescent population. India, home to the largest adolescent population and the second largest diabetes cohort is experiencing rapid but unplanned urbanization, with accompanying unhealthy nutritional transition, and sedentary lifestyle.</p><p><strong>Aim: </strong>To determine prevalence and determinants of obesity and hyperglycaemia and their association among community-dwelling older adolescents (15-19 years) in India.</p><p><strong>Methods: </strong>This cross-sectional analysis from the national family health survey-5 included data of 258028 adolescents aged 15-19 across India (2019-2021). The survey employed stratified two-stage sampling, with systematic random sampling in rural and urban areas. Statistical analysis included descriptive statistics, bivariate, and multivariable logistic regression, employing generalized linear models.</p><p><strong>Results: </strong>The weighted prevalence of DM was 1.09% including 0.77% [95% confidence interval (CI): 0.72-0.83] previously diagnosed and 0.32% (95%CI: 0.29-0.35) newly diagnosed cases detected on survey screening. On adjusted analysis, increasing age, higher education levels, higher wealth index, and overweight/obesity were the factors significantly associated with presence of DM. Only 61% of the adolescents with previously diagnosed DM were on anti-diabetes treatment. The weighted prevalence of overweight/obesity among older adolescents was 6.9% with significantly higher odds in the male sex, having higher educational levels, urban residence, and those with a higher wealth index.</p><p><strong>Conclusion: </strong>Nearly one in hundred older adolescents in India have diabetes, with one in three undiagnosed. Strengthening DM screening and treatment access among adolescents through public health programs is urgently warranted.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 4","pages":"91638"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803915","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":"Understanding serum inflammatory markers in pediatric <i>Mycoplasma pneumoniae</i> pneumonia.","authors":"Basavraj S Nagoba, Shree V Dhotre, Ajay M Gavkare, Sachin S Mumbre, Pradnya S Dhotre","doi":"10.5409/wjcp.v13.i4.98809","DOIUrl":"10.5409/wjcp.v13.i4.98809","url":null,"abstract":"<p><p>This editorial reflects on the research, which investigates the potential of serum markers to predict the severity of <i>Mycoplasma pneumoniae</i> infections. <i>Mycoplasma pneumoniae</i> pneumonia (MPP) is a prevalent cause of respiratory infections in children, often leading to significant morbidity. Predicting the severity of MPP can significantly enhance patient management and outcomes. This editorial reviews the role of specific laboratory markers: (1) Lactate dehydrogenase; (2) Interleukin (IL)-6; (3) IL-10; (4) Tumor necrosis factor-α; and (5) D-dimer in predicting the severity of MPP in pediatric patients. Elevated levels of these markers are strongly associated with severe cases of MPP, providing clinicians with valuable tools for early diagnosis and targeted intervention.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 4","pages":"98809"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803916","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":"Prediction of cyanotic and acyanotic congenital heart disease using machine learning models.","authors":"Sana Shahid, Haris Khurram, Apiradee Lim, Muhammad Farhan Shabbir, Baki Billah","doi":"10.5409/wjcp.v13.i4.98472","DOIUrl":"10.5409/wjcp.v13.i4.98472","url":null,"abstract":"<p><strong>Background: </strong>Congenital heart disease is most commonly seen in neonates and it is a major cause of pediatric illness and childhood morbidity and mortality.</p><p><strong>Aim: </strong>To identify and build the best predictive model for predicting cyanotic and acyanotic congenital heart disease in children during pregnancy and identify their potential risk factors.</p><p><strong>Methods: </strong>The data were collected from the Pediatric Cardiology Department at Chaudhry Pervaiz Elahi Institute of Cardiology Multan, Pakistan from December 2017 to October 2019. A sample of 3900 mothers whose children were diagnosed with cyanotic or acyanotic congenital heart disease was taken. Multivariate outlier detection methods were used to identify the potential outliers. Different machine learning models were compared, and the best-fitted model was selected using the area under the curve, sensitivity, and specificity of the models.</p><p><strong>Results: </strong>Out of 3900 patients included, about 69.5% had acyanotic and 30.5% had cyanotic congenital heart disease. Males had more cases of acyanotic (53.6%) and cyanotic (54.5%) congenital heart disease as compared to females. The odds of having cyanotic was 1.28 times higher for children whose mothers used more fast food frequently during pregnancy. The artificial neural network model was selected as the best predictive model with an area under the curve of 0.9012, sensitivity of 65.76%, and specificity of 97.23%.</p><p><strong>Conclusion: </strong>Children having a positive family history are at very high risk of having cyanotic and acyanotic congenital heart disease. Males are more at risk and their mothers need more care, good food, and physical activity during pregnancy. The best-fitted model for predicting cyanotic and acyanotic congenital heart disease is the artificial neural network. The results obtained and the best model identified will be useful for medical practitioners and public health scientists for an informed decision-making process about the earlier diagnosis and improve the health condition of children in Pakistan.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 4","pages":"98472"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803913","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":"Diazoxide toxicity in congenital hyperinsulinism: A case report.","authors":"Roberta Pajno, Camilla Visconti, Carmen Bucolo, Maria Pia Guarneri, Paolo Del Barba, Paolo Silvani, Marco Gregnanin, Graziano Barera","doi":"10.5409/wjcp.v13.i4.94156","DOIUrl":"10.5409/wjcp.v13.i4.94156","url":null,"abstract":"<p><strong>Background: </strong>Diazoxide is the sole approved drug for congenital hyperinsulinism; however, diuretic administration and vigilant monitoring are crucial to prevent and promptly identify potentially life-threatening adverse effects. This report aims to highlight a seldom-considered rare side effect of diazoxide. We believe that this brief report is of general interest to <i>World Journal of Clinical Pediatric</i> readership and increase the physicians' awareness of the guideline importance. Moreover, it underlines the importance of stopping immediately the drug if suspected side effects.</p><p><strong>Case summary: </strong>The manuscript describes a patient diagnosed with congenital hyperinsulinism (CHI) treated with diazoxide not overlapping with diuretic. He resulted in sudden respiratory distress and therefore was transferred to the Neonatal Intensive Care Unit. The cardiological evaluation showed pericardial effusion and left ventricular myocardial hypertrophy, absent before. In suspicion of an iatrogenic effect of diazoxide it was progressively reduced until stop while introducing diuretic treatment, with resolution of symptoms. Once clinically stabilized, an 18 fluoro-diydroxy-phenylalanine positron emission tomography/computed tomography (PET/CT) was performed to differentiate between a focal or diffuse form of CHI. The PET/CT highlighted the presence of a single focal accumulation of the tracer located in the pancreatic tail, consistent with a focal form of hyperinsulinism. At the age of four months, the patient underwent a distal pancreatectomy with histological confirmation of a focal form of nesidioblastosis, resulting in a curative operation.</p><p><strong>Conclusion: </strong>Diuretic administration and vigilant monitoring of diazoxide therapy are crucial to prevent and promptly identify potentially life-threatening adverse effects.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 4","pages":"94156"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11572624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803801","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 and laboratory features of juvenile idiopathic arthritis with wrist involvement: Results of a retrospective cohort study.","authors":"Lyubov Sorokina, Maria Kaneva, Artem Artamonov, Natalia Gordeeva, Irina Chikova, Mikhail Kostik","doi":"10.5409/wjcp.v13.i3.91656","DOIUrl":"10.5409/wjcp.v13.i3.91656","url":null,"abstract":"<p><strong>Background: </strong>Previous studies in the pre-biological era showed an association of wrist inflammation in juvenile idiopathic arthritis (JIA) with progressive disease course, polyarticular involvement and failure of methotrexate treatment.</p><p><strong>Aim: </strong>To describe features of JIA, associated with wrist arthritis.</p><p><strong>Methods: </strong>Data from about 753 JIA patients were included in this retrospective cohort study. The clinical and laboratory features of patients with and without wrist involvement were analyzed.</p><p><strong>Results: </strong>Wrist involvement was found in oligoarthritis (5.8%), RF(-)/RF(+) polyarthritis (44.9%/15.0%), enthesitis-related arthritis (17.7%), and systemic (58.6%) JIA categories. Unilateral wrist involvement was typical for oligoarthritis patients, bilateral involvement was either equal to that of unilateral involvement or was more frequent in other categories. Wrist arthritis was found to be associated with female sex, a low incidence of uveitis, and more indications of systemic inflammation, including elevated levels of C-reactive protein, erythrocyte sedimentation rate, and platelets, as well as involvement of the cervical spine, temporomandibular, shoulder, elbow, metacarpophalangeal, proximal interphalangeal, distal interphalangeal, hip, ankle, and tarsus arthritis. The number of patients with hip osteoarthritis and hip replacement was also higher. Wrist arthritis was associated with a lower probability of achieving remission [hazard ratio (HR) = 1.3 (95%CI: 1.0-1.7), <i>P</i> = 0.055], and a higher probability of being treated with biologics [HR = 1.7 (95%CI: 1.3-2.10, <i>P</i> = 0.00009)].</p><p><strong>Conclusion: </strong>Wrist arthritis in JIA patients is a marker of a severe disease course, characterized by more intensive inflammation, unfavorable outcomes, and. requiring more intensive treatment with early administration of biologics. Close monitoring of wrist inflammation with ultrasound and MR assessment with early biological treatment might improve the outcomes.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 3","pages":"91656"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334110","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":"Transabdominal intestinal ultrasound and its parameters used in the assessment of pediatric inflammatory bowel disease.","authors":"Kevan J English","doi":"10.5409/wjcp.v13.i3.96646","DOIUrl":"10.5409/wjcp.v13.i3.96646","url":null,"abstract":"<p><p>This article extends on the use of transabdominal intestinal ultrasound in diagnosing pediatric inflammatory bowel disease. Some of the more essential features used in assessing bowel inflammation, such as hyperemia and wall thickness on ultrasound, are expanded upon from the publication on imaging and endoscopic tools in pediatric inflammatory bowel disease.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 3","pages":"96646"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334118","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":"Quieting the neonatal intensive care unit: A quality improvement initiative.","authors":"Darshan Rajatadri Rangaswamy, Niranjan Kamble, Amulya Veeramachaneni","doi":"10.5409/wjcp.v13.i3.96018","DOIUrl":"10.5409/wjcp.v13.i3.96018","url":null,"abstract":"<p><strong>Background: </strong>The neonatal intensive care unit (NICU) is vital for preterm infants but is often plagued by harmful noise levels. Excessive noise, ranging from medical equipment to conversations, poses significant health risks, including hearing impairment and neurodevelopmental issues. The American Academy of Pediatrics recommends strict sound limits to safeguard neonatal well-being. Strategies such as education, environmental modifications, and quiet hours have shown to reduce noise levels. However, up to 60% of the noises remain avoidable. High noise exposure exacerbates physiological disturbances, impacting vital functions and long-term neurological outcomes. Effective noise reduction in the NICU is crucial for promoting optimal neonatal development.</p><p><strong>Aim: </strong>To measure the sound levels in a NICU and reduce ambient sound levels by at least 10% from baseline.</p><p><strong>Methods: </strong>A quasi-experimental quality improvement project was conducted over 4 mo in a 20-bed level 3 NICU in a tertiary care medical college. Baseline noise levels were recorded continuously using a sound level meter. The interventions included targeted education, environmental modifications, and organizational changes, and were implemented through three rapid Plan-Do-Study-Act (PDSA) cycles. Weekly feedback and monitoring were conducted, and statistical process control charts were used for analysis. The mean noise values were compared using the paired <i>t</i>-test.</p><p><strong>Results: </strong>The baseline mean ambient noise level in the NICU was 67.8 dB, which decreased to 50.5 dB after the first cycle, and further decreased to 47.4 dB and 51.2 dB after subsequent cycles. The reduction in noise levels was 21% during the day and 28% at night, with an overall decrease of 25% from baseline. The most significant reduction occurred after the first PDSA cycle (mean difference of -17.3 dB, <i>P</i> < 0.01). Peak noise levels decreased from 110 dB to 88.24 dB after the intervention.</p><p><strong>Conclusion: </strong>A multifaceted intervention strategy reduced noise in the NICU by 25% over 4 months. The success of this initiative emphasizes the significance of comprehensive interventions for noise reduction.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 3","pages":"96018"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334116","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 iron deficiency anemia in inflammatory bowel disease.","authors":"Seema Rai","doi":"10.5409/wjcp.v13.i3.93697","DOIUrl":"10.5409/wjcp.v13.i3.93697","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a relapsing chronic inflammatory disorder of the small and large gut with rising incidence and prevalence worldwide. Iron deficiency anemia is one of the most common extraintestinal manifestations of IBD, which correlates with the disease activity and tendency to relapse even after successful management. Anemia affects various aspects of quality of life, such as physical, cognitive, emotional, and workability, as well as healthcare costs. The anemia in IBD can be due to iron deficiency (ID) or chronic disease. The relative frequency of ID in IBD is 60%, according to some studies, and only 14% receive treatment. The evaluation of ID is also tricky as ferritin, being an inflammatory marker, also rises in chronic inflammatory diseases like IBD. The review of anemia in IBD patients involves other investigations like transferrin saturation and exploration of other nutritional deficiencies to curb the marker asthenia with which these patients often present. It underscores the importance of timely investigation and treatment to prevent long-term sequelae. We can start oral iron therapy in certain circumstances. Still, as inflammation of the gut hampers iron absorption, an alternative route to bypass the inflamed gut is usually recommended to avoid the requirement for blood transfusions.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 3","pages":"93697"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334117","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":"Built environment and childhood obesity.","authors":"Gumpeny R Sridhar, Lakshmi Gumpeny","doi":"10.5409/wjcp.v13.i3.93729","DOIUrl":"10.5409/wjcp.v13.i3.93729","url":null,"abstract":"<p><p>Childhood obesity, an escalating global health challenge, is intricately linked to the built environment in which children live, learn, and play. This review and perspective examined the multifaceted relationship between the built environment and childhood obesity, offering insights into potential interventions for prevention. Factors such as urbanization, access to unhealthy food options, sedentary behaviors, and socioeconomic disparities are critical contributors to this complex epidemic. Built environment encompasses the human-modified spaces such as homes, schools, workplaces, and urban areas. These settings can influence children's physical activity levels, dietary habits, and overall health. The built environment can be modified to prevent childhood obesity by enhancing active transportation through the development of safe walking and cycling routes, creating accessible and inviting green spaces and play areas, and promoting healthy food environments by regulating fast-food outlet density. School design is another area for intervention, with a focus on integrating outdoor spaces and facilities that promote physical activity and healthy eating. Community engagement and education in reinforcing healthy behaviors is necessary, alongside the potential of technology and innovation in encouraging physical activity among children. Policy and legislative support are crucial for sustaining these efforts. In conclusion, addressing the built environment in the fight against childhood obesity requires the need for a comprehensive, multipronged approach that leverages the built environment as a tool for promoting healthier lifestyles among children, ultimately paving the way for a healthier, more active future generation.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 3","pages":"93729"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334109","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 predisposition to childhood cancer.","authors":"Jelena Roganovic","doi":"10.5409/wjcp.v13.i3.95010","DOIUrl":"10.5409/wjcp.v13.i3.95010","url":null,"abstract":"<p><p>The etiology of childhood cancer remains largely unknown. Recent evidence suggests that genetic factors play a substantial role in pediatric tumorigenesis. Unlike adult cancers, pediatric cancers typically have a higher prevalence of germline pathogenic variants in cancer predisposition genes. Inherited cancer predisposition syndromes account for approximately 10% of all childhood cancers. Over the years, the diagnosis of cancer predisposition syndromes was based on clinical suspicion prompting referral to a specialized geneticist. However, advances in molecular technologies have led to a shift toward a \"genotype-first\" approach. Identification of genetic variants related to cancer predisposition enables tailored treatment, improves clinical outcome, optimizes surveillance, and facilitates genetic counseling of the affected child and the family.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"13 3","pages":"95010"},"PeriodicalIF":0.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11438921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142334113","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}