World journal of clinical pediatrics最新文献

{"title":"Visceral adiposity index and cardiorespiratory fitness: Unmasking risk of impaired fasting glucose among adolescents.","authors":"Ravi Shah, Rimesh Pal, Juniali Hatwal, Akash Batta, Bishav Mohan","doi":"10.5409/wjcp.v14.i2.103442","DOIUrl":"10.5409/wjcp.v14.i2.103442","url":null,"abstract":"<p><p>Type 2 diabetes mellitus (T2DM) is increasing among adolescents, but paediatric risk predictors are relatively underdeveloped. This study aimed to establish the associations of visceral adiposity index (VAI) and cardiorespiratory fitness (CRF) with fasting plasma glucose in 418 Nigerian adolescents aged 11 years to 19 years. Using a cross-sectional design, participants were stratified by VAI and CRF tertiles to examine variations in impaired fasting glucose (IFG) risk. The findings of this study revealed significant gender differences: In the case of boys, high VAI and low CRF is associated with IFG, while no association was present in girls. CRF, measured by the 20-meter shuttle run, was a stronger predictor of IFG than VAI, suggesting that physical fitness is a protective factor against glucose dysregulation. These findings point to VAI and CRF as useful, non-invasive predictors of risk for T2DM in youth, supporting school-based fitness programs that promote CRF and attenuate visceral adiposity, particularly in males. Future work must validate these predictors across various ethnic populations and identify other risk factors that can augment plans for early interventions aimed at the prevention of adolescent T2DM.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"103442"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259535","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 genetic diagnosis and management of Silver-Russell syndrome: Report of four cases.","authors":"Ilektra Toulia, Parthena Savvidou, Athina Ververi, Maria G Grammatikopoulou, Konstantina Kosta, Vaya Tziaferi, Charalampos Antachopoulos, Dimitrios G Goulis, Alexandros Sotiriadis, Kyriaki Tsiroukidou","doi":"10.5409/wjcp.v14.i2.100330","DOIUrl":"10.5409/wjcp.v14.i2.100330","url":null,"abstract":"<p><strong>Background: </strong>Silver-Russell syndrome (SRS) is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction, relative macrocephaly at birth, distinct facial features, and body asymmetry combined with other malformations.</p><p><strong>Case summary: </strong>Herein, we describe four individuals with SRS, focusing on their prenatal phenotype, postnatal presentation, diagnosis, and management. All cases had a typical phenotype, including postnatal growth failure, short stature (chronic malnutrition), and protruding forehead. Individually, they presented with feeding difficulties, leg length discrepancy, triangular face, or relative macrocephaly at birth, and each one exhibited distinct SRS features, including motor and/or speech delay, experiencing frequent hypoglycemic episodes. The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.</p><p><strong>Conclusion: </strong>SRS is diagnosed clinically. However, only 60% of cases are genetically confirmed, while most are sporadic. Although SRS is a well-described syndrome, a delayed diagnosis can have grave consequences on a child's growth. Recombinant human growth hormone treatment is often initiated shortly after the diagnosis. The follow-up requires a multidisciplinary approach.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"100330"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259583","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":"Impact of nutritional status on the outcome of critically ill pediatric patients.","authors":"Samriddhi Jain, Amit Agrawal, Shweta Sharma, Ramkumar Chinnadurai","doi":"10.5409/wjcp.v14.i2.103377","DOIUrl":"10.5409/wjcp.v14.i2.103377","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition among patients admitted to a pediatric intensive care unit (PICU) is common. However, there is a lack of data on its impact on the critically ill.</p><p><strong>Aim: </strong>To assess the impact of nutritional status on the outcome of critically ill children admitted to PICU.</p><p><strong>Methods: </strong>This observational study was conducted in a tertiary care teaching institute for one year, including 210 children aged 1 month to 14 years admitted to a 15-bed PICU for a minimum of 24 hours. Patients with less than 24 hours of PICU stay, who received palliative care, or with syndromic short stature were excluded. Relevant data were collected including anthropometric details, demographic data, duration of mechanical ventilation (MV), PICU, and hospital stay and outcome. Malnourished and well-nourished groups were compared using an independent <i>t</i>-test, one-way analysis of variance, and <i>χ</i> ² test.</p><p><strong>Results: </strong>Among 210 patients, there were 129 males and 81 females. There were 57 (27.1%) children less than 6 months of age, 95 (45.2%) between 6 months and 5 years, and 58 (27.6%) more than 5 years of age. The prevalence of malnutrition in the study sample was 51.9% (<i>n</i> = 109). The overall mortality was 22.9% (48/210), 26.6% (29/109) among malnourished, and 18.8% (19/101) among well-nourished children (<i>P</i> = 0.241). A significant association was found between the severity of malnutrition and duration of MV (<i>P</i> = 0.001), PICU stay (<i>P</i> = 0.001), and hospital stay (<i>P</i> = 0.021).</p><p><strong>Conclusion: </strong>Malnutrition is common in critically ill children and contributes to poor clinical outcomes such as duration of MV, PICU, and hospital stay. However, mortality was comparable in both groups.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"103377"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259593","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":"Parental presence in the pediatric intensive care unit reduces postoperative sedative requirements: A retrospective study.","authors":"Vitaliy Sazonov, Alpamys Issanov, Sayazhan Turar, Zaure Tobylbayeva, Olga Mironova, Askhat Saparov, Dmitriy Viderman","doi":"10.5409/wjcp.v14.i2.102049","DOIUrl":"10.5409/wjcp.v14.i2.102049","url":null,"abstract":"<p><strong>Background: </strong>Although critically ill pediatric patients can benefit from the use of sedation, it can cause side effects and even iatrogenic complications. Since pediatric patients cannot adequately express the intensity or location of the pain, discriminating the cause of their irritability and agitation can be more complicated than in adults. Thus, sedation therapy for children requires more careful attention.</p><p><strong>Aim: </strong>To evaluate the association of the internal parental care protocol and the reduction in pediatric intensive care unit (PICU) postoperatively.</p><p><strong>Methods: </strong>This retrospective cohort study was carried out in the PICU of the tertiary medical center in Kazakhstan. The internal parental care protocol was developed and implemented by critical care team. During the pandemic, restrictions were also placed on parental presence in the PICU. We compare two groups: During restriction and after return to normal. The level of agitation was evaluated using the Richmond Agitation-Sedation Scale. Univariate and multivariate logistic regression analyses were performed to examine associations of parental care with sedation therapy.</p><p><strong>Results: </strong>A total of 289 patients were included in the study. Of them, 167 patients were hospitalized during and 122 after the restrictions of parental care. In multivariate analysis, parental care was associated with lower odds of prescribing diazepam (odds ratio = 0.11, 95% confidence interval: 0.05-0.25), controlling for age, sex, cerebral palsy, and type of surgery.</p><p><strong>Conclusion: </strong>The results of this study show that parental care was associated only with decreased odds of prescribing sedative drugs, while no differences were observed for analgesics.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"102049"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259595","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 course and management of hypertriglyceridemia thalassemia syndrome: A case-based systematic review.","authors":"Chane Choed-Amphai, Pattranan Kusontammarat, Supapitch Chanthong, Nattawan Arkarattanakul, Poonyapon Rodchaprom, Lalita Sathitsamitphong, Rungrote Natesirinilkul, Pimlak Charoenkwan","doi":"10.5409/wjcp.v14.i2.101543","DOIUrl":"10.5409/wjcp.v14.i2.101543","url":null,"abstract":"<p><strong>Background: </strong>Hypertriglyceridemia thalassemia syndrome is a rare condition that occurs in patients with thalassemia. It typically presents with a combination of profound anemia and milky serum. Although previous case series have demonstrated the benefit of blood transfusions in reducing serum triglycerides, information regarding clinical outcomes and standard management in this setting remains limited.</p><p><strong>Aim: </strong>To identify the clinical course, treatment strategies, and outcomes of patients with hypertriglyceridemia thalassemia syndrome.</p><p><strong>Methods: </strong>We performed a comprehensive search of the Scopus, PubMed, and Embase databases. We included only English-language articles and did not apply any publication date limits. The databases were last accessed on September 1, 2024. This study was registered under number CRD420250587918 and included studies involving children and adults with thalassemia, hypertriglyceridemia, and available data on clinical course.</p><p><strong>Results: </strong>A total of 14 publications were included in the analysis, all of which were case reports or case series. No higher-quality evidence was available. Among 28 children with hypertriglyceridemia thalassemia syndrome, there were 22 cases of β-thalassemia major and 6 cases of hemoglobin E/β-thalassemia, including our illustrative case. The median age of onset was 11 months, and 92.3% of cases presented prior to the first blood transfusion. The common clinical manifestations included pallor (100%) and hepatosplenomegaly (67.9%). For hypertriglyceridemia-related symptoms, lipemia retinalis and xanthomas were observed in 25.0% and 10.7% of cases, respectively. The median hemoglobin level was 5.5 g/dL, while the median triglyceride level was 935 mg/dL. For management, 92.9% of cases received blood transfusions with or without other interventions. At a median of 12 months' follow-up, all patients responded to the treatment without lipid-lowering agents, and 85.7% of cases were alive.</p><p><strong>Conclusion: </strong>Hypertriglyceridemia thalassemia syndrome occurs exclusively in young children and usually presents with anemia and severe hypertriglyceridemia prior to the first transfusion. Management with blood transfusions provides a favorable response. However, long-term regular monitoring is warranted.</p>","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"14 2","pages":"101543"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259584","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":"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}