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Congenital anomalies of coronary artery misdiagnosed as coronary dilatations in Kawasaki disease:A clinical predicament

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World Journal of Clinical pediatrics 2025年第1期14卷 93-100页

作者： Rakesh Kumar Pilania Pallavi L Nadig Suprit Basu Reva Tyagi Abarna Thangaraj Ridhima Aggarwal Munish Arora Arun Sharma Surjit Singh Manphool Singhal pediatric Allergy Immunology Unit Department of PediatricsAdvanced Pediatrics CenterPost Graduate Institute of Medical Education and ResearchChandigarh 160012ChandīgarhIndia department of Radiodiagnosis and Imaging Postgraduate Institute of Medical Education and ResearchChandigarh 160012ChandīgarhIndia

BACKGROUND 2D-echocardiography(2DE)has been the primary imaging modality in children with Kawasaki disease(KD)to assess coronary *** To report the presence and implications of incidental congenital coronary artery anomalies that had been misinterpreted as coronary artery abnormalities(CAAs)on *** Records of children diagnosed with KD,who underwent computed tomography coronary angiography(CTCA)at our center between 2013-2023 were *** identified 3 children with congenital coronary artery anomalies in this cohort on *** of CTCA and 2DE were compared in these 3 *** Of the 241 patients with KD who underwent CTCA,3(1.24%)had congenital coronary artery anomalies on CTCA detected *** all 3 patients,baseline 2DE had identified *** was then performed for detailed evaluation as per our unit ***(11-year-boy)amongst the 3 patients had complete KD,while the other two(3.3-year-boy;4-month-girl)had incomplete *** revealed separate origins of left anterior descending artery and left circumflex from left sinus[misinterpreted as dilated left main coronary artery(LCA)on 2DE],single coronary artery(interpreted as dilated LCA on 2DE)and dilated right coronary artery on 2DE in case of anomalous origin of LCA from the main pulmonary *** latter one was subsequently operated *** CTCA is essential for detailed assessment of coronary arteries in children with KD especially in cases where there is suspicion of congenital coronary artery *** solely on 2DE may not be sufficient in such cases,and findings from CTCA can significantly impact therapeutic decision-making.

关键词： Coronary artery abnormalities Congenital coronary artery anomalies Computed tomography coronary angiography Kawasaki disease 2-dimensional echocardiography

Inflammasome links traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1644-1664页

作者： Gabriela Seplovich Yazan Bouchi Juan Pablo de Rivero Vaccari Jennifer C.Munoz Pareja Andrew Reisner Laura Blackwell Yehia Mechref Kevin K.Wang J.Adrian Tyndall Binu Tharakan Firas Kobeissy department of Surgery Morehouse School of MedicineAtlantaGAUSA department of Neurobiology Center for NeurotraumaMultiomics&Biomarkers(CNMB)Neuroscience InstituteMorehouse School of MedicineAtlantaGAUSA department of Neurological Surgery and the Miami Project to Cure Paralysis University of Miami Miller School of MedicineMiamiFLUSA Division of pediatric Critical Care Department of PediatricsUniversity of Miami Miller School of MedicineMiamiFLUSA department of pediatrics Emory UniversityAtlantaGAUSA department of Neurosurgery Children’s Healthcare of AtlantaAtlantaGAUSA department of Chemistry and Biochemistry Texas Tech UniversityLubbockTXUSA Morehouse School of Medicine AtlantaGAUSA

Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.

关键词： Alzheimer's disease caspase-1 chronic traumatic encephalopathy inflammasomes neurodegeneration neuroinflammation NLRP1 NLRP3 pyroptosis tauopathy traumatic brain injury

Cardiovascular involvement in multisystem inflammatory syndrome in children and midterm follow-up from a pediatric tertiary center in India

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World Journal of Clinical pediatrics 2025年第1期14卷 127-138页

作者： Poovazhagi Varadarajan Ritchie Sharon Solomon Seenivasan subramani Ramesh subramanian Gomathy Srividya Elilarasi Raghunathan department of pediatric Intensive Care Institute of Child Health and Hospital for ChildrenMadras Medical CollegeChennai 600003Tamil NāduIndia department of pediatric Cardiology Institute of Child Health and Hospital for ChildrenMadras Medical CollegeChennai 600003Tamil NāduIndia department of pediatrics Institute of Child Health and Hospital for ChildrenMadras Medical CollegeChennai 600003Tamil NāduIndia

BACKGROUND 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 *** planned to estimate the pattern of cardiovascular involvement among children with MIS-C and its mid-term *** To determine association between cardiovascular abnormalities and clinical and laboratory *** study the time-line for resolution of various *** In this prospective study done in a tertiary care hospital,270 were recruited from June 2020 to January *** demographic data and clinical presentation were *** parameters and echocardiography were done at ***-up was done at 2 weeks,3 months,6 months and 1 year after *** statistics were used for parametric and non-parametric *** factors were identified by multivariate regression *** The 211(78.2%)had cardiac involvement and 102 needed intensive care unit(ICU)*** 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%*** regression analysis revealed breathlessness[odds ratio(OR)=3.91,95%CI:1.25-12.21,P=0.019]and hi-flow nasal cannula(HFNC)support(OR=8.5,95%CI:1.06-68.38,P=0.044)as predictors of cardiovascular *** mean age(OR=1.16,95%CI:1.02-1.32,P=0.026),breathlessness(OR=4.99,95%CI:2.05-12.20,P<0.001),gallop(OR=4.45,95%CI:0.41-2.52,P=0.016),MR(OR=3.61,95%CI:1.53-8.53,P=0.004)and invasive ventilation(OR=4.01,95%CI:1.28-12.58,P=0.017)were predictive of LV *** sensorium(OR=4.96,95%CI:2.23-11.02,P<0.001),headache(OR=6.61,95%CI:1.46-29.92,P=0.014),HFNC(OR=7.03,95%CI:2.0

关键词： Multisystem inflammatory syndrome in children Cardiovascular Midterm follow-up Coronary artery aneurysm Shock Left ventricular dysfunction

Cortico-striatal gamma oscillations are modulated by dopamine D3 receptors in dyskinetic rats

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Neural Regeneration Research 2025年第4期20卷 1164-1177页

作者： Pengfei Wang Yuewei Bi Min Li Jiazhi Chen Zhuyong Wang Huantao Wen Ming Zhou Minjie Luo Wangming Zhang Neurosurgery Center Department of Pediatric NeurosurgeryGuangdong Provincial Key Laboratory on Brain Function Repair and RegenerationZhujiang HospitalSouthern Medical UniversityGuangzhouGuangdong ProvinceChina

Long-term levodopa administration can lead to the development of levodopa-induced *** oscillations are a widely recognized hallmark of abnormal neural electrical activity in levodopa-induced ***,studies have reported increased oscillation power in cases of levodopa-induced ***,little is known about how the other electrophysiological parameters of gamma oscillations are altered in levodopa-induced ***,the role of the dopamine D3 receptor,which is implicated in levodopa-induced dyskinesia,in movement disorder-related changes in neural oscillations is *** found that the cortico-striatal functional connectivity of beta oscillations was enhanced in a model of Parkinson’s ***,levodopa application enhanced cortical gamma oscillations in cortico-striatal projections and cortical gamma aperiodic components,as well as bidirectional primary motor cortex(M1)↔dorsolateral striatum gamma *** of PD128907(a selective dopamine D3 receptor agonist)induced dyskinesia and excessive gamma oscillations with a bidirectional M1↔dorsolateral striatum ***,administration of PG01037(a selective dopamine D3 receptor antagonist)attenuated dyskinesia,suppressed gamma oscillations and cortical gamma aperiodic components,and decreased gamma causality in the M1→dorsolateral striatum *** findings suggest that the dopamine D3 receptor plays a role in dyskinesia-related oscillatory activity,and that it has potential as a therapeutic target for levodopa-induced dyskinesia.

关键词： aperiodic components dopamine D3 receptor dorsolateral striatum functional connectivity gamma oscillations levodopa-induced-dyskinesia local field potentials neuromodulation Parkinson’s disease primary motor cortex

Mycoplasma pneumoniae pneumonia in children

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World Journal of Clinical Cases 2025年第5期13卷 61-67页

作者： Thakoon Butpech Prakarn Tovichien department of pediatrics Faculty of Medicine Siriraj HospitalMahidol UniversityBangkok 10700Thailand

Mycoplasma pneumoniae(***)is a common pathogen that causes community-acquired pneumonia in *** clinical presentation of this pathogen can range from mild self-limiting illness to severe and refractory *** may occur,such as necrotizing pneumonia and respiratory *** complications,including encephalitis,myocarditis,nephritis,hepatitis,or even multiple organ failure,can also *** this editorial,we dis-cuss the clinical implications of the significant findings from the article"Serum inflammatory markers in children with *** pneumonia and their predictive value for mycoplasma severity"published by Wang et *** reported that measuring lactic dehydrogenase,interleukin-6 levels,and D-dimer effectively predicts refractory *** pneumonia cases.

关键词： Cytokine Mycoplasma pneumoniae pneumonia Children,Community-acquired pneumonia Lactic dehydrogenase Interleukin-6

Relevance of epidemiology data in trauma management

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World Journal of Clinical Cases 2025年第9期13卷 65-67页

作者： Krishna Kumar Govindarajan department of pediatric Surgery Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Trauma is a major cause of morbidity and mortality across the globe accounting for significant health *** of trauma care revolves round prevention,planning and execution of safety *** of the actual data regarding the type of trauma,affected age group,timings of trauma occurrence,involved part of the body constitute the initial steps in the building of the composite overview of the epidemiology of *** succession,would be the measures directed towards avoidance of trauma and capacity building of trauma center.

关键词： Trauma Epidemiology Injury Prevention Triage Registry Artificial Intelligence

Biologics in the management of pediatric inflammatory bowel disease:When and what to choose

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World Journal of Clinical pediatrics 2025年第1期14卷 21-45页

作者： Arghya Samanta Anshu Srivastava department of pediatric Gastroenterology Sanjay Gandhi Postgraduate Institute of Medical SciencesLucknow 226014Uttar PradeshIndia

pediatric inflammatory bowel disease(PIBD)is a chronic inflammatory disorder of the gastrointestinal tract,with rising global incidence and *** the past two decades,biologics have added to the therapeutic armamentarium and revolutionized the approach to treatment of inflammatory bowel *** 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 *** 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 *** real-world studies are available regarding the clinical efficacy of biologics in PIBD,there is paucity of long-term outcome and safety data in ***,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 *** 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.

关键词： Biologics Children Inflammatory bowel disease Therapeutic drug monitoring Dual biologic

Saccharomyces boulardii as a single trigger of food protein-induced enterocolitis syndrome: Seven case reports

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World Journal of Clinical Cases 2025年第6期13卷 35-40页

作者： Jin-Bok Hwang Hyo-Jeong Jang department of pediatrics Keimyung University School of MedicineDongsan Medical CenterDaegu 42601South Korea

BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to *** boulardii(***),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered *** this report,we describe a new clinical FPIES in which *** was the sole triggering factor of acute FPIES adverse reaction in seven healthy *** SUMMARY Seven FPIES cases triggered by only *** were gathered from 2011 to the *** of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary *** age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of ***,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated *** patients experienced severe repetitive vomiting 1-3 hours after *** *** lethargy,marked pallor,and cyanosis were also *** IgE-mediated hypersensitivity developed in any *** was followed by initial intense vomiting in approximately 5-10 hours after *** ingestion,and only one case showed bloody,purulent,and foul-smelling *** patients stabilized quickly,mostly within 6 *** got all improved within 24 hours after discontinuation of *** *** can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.

关键词： Food protein-induced enterocolitis syndrome Food hypersensitivity Saccharomyces boulardii Probiotics Child Case report

Clinical,laboratory,and therapeutic differences between immunoglobulin E-mediated and non-immunoglobulin E-mediated cow’s milk protein allergy in children

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World Journal of Clinical pediatrics 2025年第1期14卷 78-92页

作者： Hasan M Isa Marwa J Abdulnabi Nawra S Naser Fatema N Lahmda Noor M AlAnsari Zahra H Isa Afaf M Mohamed department of pediatrics Salmaniya Medical ComplexManama 26671Bahrain department of pediatrics Arabian Gulf UniversityManama 26671Bahrain Faculty of Medicine Mansoura UniversityMansoura 35516Egypt Public Health Directorate Ministry of HealthManama 26671Bahrain

BACKGROUND 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).AIM To evaluate CMPA prevalence in Bahrain and compare clinical characteristics of children with immunoglobulin E(IgE)-and non-IgE-mediated *** 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 *** presentations,laboratory findings,dietary modifications,and outcomes were compared between children with IgE-mediated and non-IgE-mediated *** variables were compared using Fisher’s exact test or Pearson’sχ2 test,whereas continuous variables were compared using Student’s t-test or the Mann-Whitney U *** Of 8332 patients,6022(72.3%)adhered to their *** 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(P=0.030),and later in life(5.1 months±4.5 months vs 4.2 months±4.2 months,P=0.016,95%CI:0.08-1.73),had more associated diseases(P<0.001);and presented with more cutaneous(P=0.024)and respiratory(P=0.003)manifestations,severe symptoms[rash/dry skin(P=0.031),facial swelling/angioedema(P=0.003),failure to thrive(P=0.013),apparent life-threatening event(P<0.001)],and positive physical findings(P=0.002)than non-IgE-mediated *** 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(P=0.173).Although breastfeeding was recommended to 49.6%,only 8.2%were exclusively ***-mediated CMPA was associated with a longer follow-up duration than non-IgE-mediated CMPA(17.3 months±14.0 mo

关键词： Children Milk allergy Immunoglobulin E Breastfeeding Infant formula Bahrain