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Imperative for long-term management and surveillance in Kawasaki disease

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World Journal of Clinical Cases 2025年第4期13卷 61-63页

作者： Yan Pan Fu-Yong Jiao department of pediatrics The First Affiliated Hospital of Yangtze UniversityJingzhou 434000Hubei ProvinceChina Shaanxi Kawasaki Disease Diagnosis and Treatment Center Children’s HospitalShaanxi Provincial People’s Hospital of Xi’an Jiaotong UniversityXi’an 710000Shaanxi ProvinceChina

Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery *** the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical *** editorial emphasizes the critical need for long-term management and regular surveillance to prevent such *** drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.

关键词： Kawasaki disease Long-term management Coronary artery aneurysm Surveillance Preventive care

Hepatitis B vaccine in celiac disease:Yesterday,today and tomorrow

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World Journal of Gastroenterology 2013年第6期19卷 838-845页

作者： Giovanna Vitaliti Andrea Domenico Praticò Carla Cimino Giovanna Di Dio Elena Lionetti Mario La Rosa Salvatore Leonardi department of pediatrics University of Catania

Some studies showed that in celiac patients the immunological response to vaccination is similar to that one found in general population except for vaccine against hepatitis B virus (HBV).The non-responsiveness to HBV vaccine has also been described in healthy people,nevertheless the number of non-responders has been demonstrated to be higher in celiac disease (CD) patients than in healthy *** hypothesis explaining this higher rate of unresponsiveness to HBV vaccine in CD patients have been described,such as the genetic hypothesis,according with CD patients carrying the disease-specific haplotype HLA-B8,DR3,and DQ2,show a lower response to HBV vaccine both in clinical expressed CD patients and in healthy people carrying the same *** the other hand,it has been demonstrated that the gluten intake during the vaccination seems to influence the response to the same ***,it has been demonstrated a possible genetic predisposition to hepatitis B vaccine nonresponsiveness likely due to the presence of specific human leukocyte antigen haplotypes and specific single nucleotide polymorphism in genes of cytokine/cytokinereceptors and toll like receptors,but the pathogenic mechanism responsible for this low responsiveness still remains *** aim of this review is to focus on the possible pathogenic causes of unresponsiveness to HBV vaccine in CD patients and to propose an alternative vaccination schedule in order to improve the responsiveness to HBV vaccine in this at-risk patients.

关键词： Celiac disease Non responders Hepatitis B vaccine Vaccination schedules

Case Report:Congenital atresia of the left main coronary artery in an infant

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Journal of Zhejiang University-Science B(Biomedicine & Biotechnology) 2010年第7期11卷 539-541页

作者： Su Ye SOHN Gi Young JANG Byung Min CHOI department of pediatrics Korea University Hospital

Congenital atresia of the left main coronary artery is a rare occurrence, and surgical revascularizationbypass graft is required. We here report a rare case of congenital coronary anomaly in an infant. A lO-month-old male infant was admitted to the hospital with heart failure symptoms. Echocardiographic examinations revealed mitral valve regurgitation and ischemic changes of the anterolateral atresia of the left main coronary artery with a severe papillary muscle and chordae. Coronary angiography showed hypoplastic left anterior descending artery and a circumflex coronary artery. Unfortunately, sudden cardiac arrest occurred after catheterization and the infant did not recover despite of immediate cardiopulmonary resuscitation. Further studies are needed to find a newer diagnostic method to detect coronary anomaly in an infant, and coronary angiography, if necessary, has to be performed very carefully.

关键词： Conqenital heart disease Anomalous coronaries Infant

Sleep and prematurity: sleep outcomes in preterm children and influencing factors

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World Journal of pediatrics 2019年第3期15卷 209-218页

作者： Maria Gogou Katerina Haidopoulou Evangelos Pavlou 2nd department of pediatrics School of MedicineAristotle University of ThessalonikiUniversity General Hospital AHEPAThessaloníkiGreece

Background Sleep undergoes changes from birth to adulthood,while sleep disorders are associated with various cognitive deficiencies in *** parallel,prematurity is known to predispose to poor neurodevelopmental *** aim is to provide literature data about factors influencing sleep in the premature infants and sleep outcomes in this *** A systematic review was conducted using a variety of health-related *** research papers were considered and no year-of-publication restriction was *** In total,22 articles fulfilled our selection *** studies present remarkable heterogeneity in terms of methodological *** to full term,premature infants exhibit significant differences in sleep structure,which mainly include differences in electroencephalographic spectral values,in total sleep time and in arousal ***,prematurity seems to be a risk factor of sleep breathing disorders in childhood and *** about the effect of methylxanthines and the environment of neonatal intensive care unit is *** regard to the impact of prematurity-related sleep disorders on future neurodevelopment,available research papers are generally *** The alterations in sleep patterns are an outcome of prematurity (immaturity of nervous system) as well as of postnatal factors and *** problems in this population of infants seems to be a missing piece of the puzzle of impaired *** studies should focus on interventions to improve sleep hygiene and limit neurodevelopmental problems.

关键词： Neonates Neurodevelopment Prematurity Sleep Sleep disorders

Rapid transport of insulin to the brain following intranasal administration in rats

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Neural Regeneration Research 2019年第6期14卷 1046-1051页

作者： Lir-Wan Fan Kathleen Carter Abhay Bhatt Yi Pang department of pediatrics University of Mississippi Medical Center

We previously reported that intranasal insulin protects substantia nigra dopaminergic neurons against6-hydroxydopamine neurotoxicity in rats. This study aimed to assess insulin pharmacokinetics in the rat brain following intranasal application. Recombinant human insulin(rh-Ins) or phosphate buffer solution was administered to both nostrils of rats. Animals were sacrificed at 15 minutes, 1, 2, and 6 hours to determine insulin levels in different brain regions by an ultrasensitive, human-specific enzyme-linked immunosorbent assay kit. For fluorescence tracing study, rats were administered with intranasal florescence-tagged insulin(Alex546-Ins), and brains were fixed at 10 and 30 minutes to prepare sagittal ***-Ins was detected in all brain regions examined except the cerebral cortex. The highest levels were detected in the brainstem, followed by the cerebellum, substantia nigra/ventral tegmental area, olfactory bulb,striatum, hippocampus, and thalamus/hypothalamus. Insulin levels reached a peak at 15 minutes and then declined gradually overtime, but remained significantly higher than baseline levels at 6 hours in most ***, widespread Alex546-Ins-binding cells were detected in the brain at 10 and 30 minutes, with the olfactory bulb and brainstem showing the highest while the cerebral cortex showing lowest fluorescence signals. Double-immunostaining showed that Alex546-Ins-bindings were primarily co-localized with neuronal nuclei-positive neurons. In the subtantia nigra, phospho-Akt was found to be activated in a subset of Alex546-Ins and tyrosine hydroxylase double-labeled cells, suggesting activation of the Akt/PI3 K pathway in these dopaminergic neurons. Data from this study suggest that intranasal insulin could effectively reach deep brain structures including the nigrostriatal pathways, where it binds to dopaminergic neurons and activates intracellular cell survival signaling. This study was approved by the Institutional Animal Care Committ

关键词： dopaminergic neurons striatum substantia nigra brainstem olfactory bulb glia trigeminal nerve pharmacokinetics axonal transport pAkt

The impact of hypoxic-ischemic brain injury on stem cell mobilization,migration,adhesion,and proliferation

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Neural Regeneration Research 2018年第7期13卷 1125-1135页

作者： Stephanie M.Parry Eric S.Peeples department of pediatrics University of Nebraska Medical Center

Neonatal hypoxic-ischemic encephalopathy continues to be a significant cause of death or neurodevelopmental delays despite standard use of therapeutic *** use of stem cell transplantation has recently emerged as a promising supplemental therapy to further improve the outcomes of infants with hypoxic-ischemic *** the injury,the brain releases several chemical mediators,many of which communicate directly with stem cells to encourage mobilization,migration,cell adhesion and *** manuscript reviews the biomarkers that are released from the injured brain and their interactions with stem cells,providing insight regarding how their upregulation could improve stem cell therapy by maximizing cell delivery to the injured tissue.

关键词： brain-derived neurotrophic hypoxia inducible erythropoietin factor matrix metalloproteinase neonatal stromal cell-derived vascular endothelial growth

Efficacy and safety of nerve growth factor for the treatment of neurological diseases:a meta-analysis of 64 randomized controlled trials involving 6,297 patients

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Neural Regeneration Research 2015年第5期10卷 819-828页

作者： Meng Zhao Xiao-yan Li Chun-ying Xu Li-ping Zou department of pediatrics Chinese PLA General Hospital

OBJECTIVE： China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine. More than 10 years ago, in 2003, nerve growth factor injection was listed as a national drug. The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases. DATA RETRIEVAL： A computer-based retrieval was performed from six databases, including the Cochrane Library, PubMed, EMBASE, Sino Med, CNKI, and the VIP database, searching from the clinical establishment of nerve growth factor for treatment until December 31, 2013. The key words for the searches were ＂nerve growth factor, randomized controlled trials＂ in Chinese and in English. DATA SELECTION： Inclusion criteria： any study published in English or Chinese referring to randomized controlled trials of nerve growth factor; patients with neurological diseases such as peripheral nerve injury, central nerve injury, cranial neuropathy, and nervous system infections; patients older than 7 years; similar research methods and outcomes assessing symptoms; and measurement of nerve conduction velocities. The meta-analysis was conducted using Review Manager 5.2.3 software. MAIN OUTCOME MEASURES： The total effective rate, the incidence of adverse effects, and the nerve conduction velocity were recorded for each study. RESULTS： Sixty-four studies involving 6,297 patients with neurological diseases were included. The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group （P 〈 0.0001, RR： 1.35, 95%CI： 1.30-1.40）. The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group （P 〈 0.00001, MD. 4.59 m/s, 95%CI： 4.12-5.06）. The incidence of pain or sclero- ma at the injection site in the nerve growth factor group was also higher than that in the control group （P 〈 0.00001, RR： 6.30, 95%CI： 3.53-11.27）, b

关键词： nerve regeneration neurological diseases nerve growth factor randomized controlledtrials meta-analysis adverse effects nerve conduction velocity neural regeneration

24-hour esophageal pH-monitoring in children suspected of gastroesophageal reflux disease: Analysis of intraesophageal pH monitoring values recorded in distal and proximal channel at diagnosis

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World Journal of Gastroenterology 2007年第38期13卷 5108-5115页

作者： Janusz Semeniuk Maciej Kaczmarski Ⅲ department of pediatrics Medical University of Bialystok Poland

AIM: To assess values of 24-h esophageal pH-monitoring parameters with dual-channel probe (distal and proximal channel) in children suspected of gastroesophageal reflux disease (GERD). METHODS: 264 children suspected of gastroesophageal reflux (GER) were enrolled in a study (mean age χ = 20.78 ± 17.23 mo). The outcomes of this study, immunoallerrgological tests and positive result of oral food challenge test with a potentially noxious nutrient, enabled to qualify children into particular study groups. RESULTS: 32 (12.1%) infants (group 1) had physiological GER diagnosed. Pathological acid GER was confirmed in 138 (52.3%) children. Primary GER was diagnosed in 76 (28.8%) children (group 2) and GER secondary to allergy to cow milk protein and/or other food (CMA/FA) in 62 (23.5%) children (group 3). 32 (12.1%) of them had CMA/FA (group 4-reference group), and in remaining 62 (23.5%) children neither GER nor CMA/FA was confirmed (group 5). Mean values of pH monitoring parameters measured in distal and proximal channel were analyzed in individual groups. This analysis showed statistically significant differentiation of mean values in the case of: number of episodes of acid GER, episodes of acid GER lasting > 5 min, duration of the longest episode of acid GER in both channels, acid GER index total and supine in proximal channel. Statistically significant differences of mean values among examined groups, especially between group 2 and 3 in the case of total acid GER index (only distal channel) were confirmed. CONCLUSION: 24-h esophageal pH monitoring confirmed pathological acid GER in 52.3% of children with typical and atypical symptoms of GERD. The similar pH-monitoring values obtained in group 2 and 3 confirm the necessity of implementation of differential diagnosis for primary vs secondary cause of GER.

关键词： Children Gastroesophageal reflux disease 24-h esophageal pH-monitoring 2-channel probe Gastroesophageal reflux Primary and secondary CMA/ FA Oral food challenge test

Pathogenesis of childhood idiopathic nephrotic syndrome:a paradigm shift from T-cells to podocytes

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World Journal of pediatrics 2015年第1期11卷 21-28页

作者： Kazunari Kaneko Shoji Tsuji Takahisa Kimata Tetsuya Kitao Sohsaku Yamanouchi Shogo Kato department of pediatrics Kansai Medical University2-5-1 Shin-machiHirakataOsaka 573-1010Japan

Background:Nephrotic syndrome is the most common cause of kidney disease in children,but its pathogenesis remains *** article reviews the novel aspects of the mechanisms underlying massive proteinuria in minimal-change disease,which is the most common form of childhood nephrotic *** sources:This article integrates the findings of a PubMed database search for English language articles published in the past 40 years(from September 1974 to February 2014)using the key words"pathogenesis","minimal change nephrotic syndrome"or"idiopathic ne phrotic syndrome".Results:Unknown humoral factors associated with T-cell dysfunction have been thought to play an important role in the pathogenesis of minimal-change ***,recent findings are changing this paradigm,i.e,visceral glomerular epithelial cells(podocytes)may be involved via expression of molecules such as CD80 and angiopoietin-like ***:Recent evidence suggests that minimal-change disease results from interactions between humoral factors and dysfunctional *** addition to immunosuppressant drugs that target lymphocytes,a biological agent such as an antibody against the abnormal molecule(S)expressed by podocytes may provide novel drug treatment for minimal-change disease.

关键词： angiopoietin-like 4 CD80 cytokine minimal change nephrotic syndrome podocyte