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Transcranial direct current stimulation as early augmentation in adolescent obsessive compulsive disorder: A pilot proof-of-concept randomized control trial. 经颅直流电刺激作为青少年强迫症的早期增强疗法:概念验证随机对照试验。
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.93138
Aditya Agrawal, Vivek Agarwal, Sujita Kumar Kar, Amit Arya

Background: Transcranial direct current stimulation (tDCS) is proven to be safe in treating various neurological conditions in children and adolescents. It is also an effective method in the treatment of OCD in adults.

Aim: To assess the safety and efficacy of tDCS as an add-on therapy in drug-naive adolescents with OCD.

Methods: We studied drug-naïve adolescents with OCD, using a Children's Yale-Brown obsessive-compulsive scale (CY-BOCS) scale to assess their condition. Both active and sham groups were given fluoxetine, and we applied cathode and anode over the supplementary motor area and deltoid for 20 min in 10 sessions. Reassessment occurred at 2, 6, and 12 wk using CY-BOCS.

Results: Eighteen adolescents completed the study (10-active, 8-sham group). CY-BOCS scores from baseline to 12 wk reduced significantly in both groups but change at baseline to 2 wk was significant in the active group only. The mean change at 2 wk was more in the active group (11.8 ± 7.77 vs 5.25 ± 2.22, P = 0.056). Adverse effects between the groups were comparable.

Conclusion: tDCS is safe and well tolerated for the treatment of OCD in adolescents. However, there is a need for further studies with a larger sample population to confirm the effectiveness of tDCS as early augmentation in OCD in this population.

背景:经颅直流电刺激(tDCS经颅直流电刺激(transcranial direct current stimulation,tDCS)被证明可安全治疗儿童和青少年的各种神经系统疾病,也是治疗成人强迫症的有效方法。目的:评估经颅直流电刺激(tDCS)作为一种附加疗法对药物无效的强迫症青少年的安全性和有效性:方法:我们使用儿童耶鲁-布朗强迫症量表(CY-BOCS)评估患有强迫症的未服药青少年的病情。活性组和假组均服用氟西汀,我们在辅助运动区和三角肌上使用阴极和阳极,每次20分钟,共10次。在 2、6 和 12 周时使用 CY-BOCS 进行重新评估:结果:18 名青少年完成了研究(10 个主动组,8 个被动组)。从基线到 12 周的 CY-BOCS 分数在两组中都有显著下降,但从基线到 2 周的变化仅在积极组中显著。积极治疗组在 2 周时的平均变化更大(11.8 ± 7.77 vs 5.25 ± 2.22,P = 0.056)。结论:tDCS 治疗青少年强迫症安全且耐受性良好。结论:tDCS治疗青少年强迫症安全且耐受性良好,但仍需对更大样本人群进行进一步研究,以确认tDCS作为强迫症早期增强疗法对该人群的有效性。
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引用次数: 0
Unique presentation of neonatal liver failure: A case report 新生儿肝功能衰竭的独特表现:病例报告
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.92263
Eman Al Atrash, Amer Azaz, Samar Said, Mohammad Miqdady
BACKGROUND Acute fulminant liver failure rarely occurs in the neonatal period. The etiologies include viral infection (15%), metabolic/genetic disease (10%), hematologic disorders (15%), and ischemic injury (5%). Gestational alloimmune liver disease usually manifests as severe neonatal liver failure, with extensive hepatic and extrahepatic iron overload, sparing the reticuloendothelial system. Empty liver failure is a rare cause of liver failure where a patient presents with liver failure in the neonatal period with no hepatocytes in liver biopsy. CASE SUMMARY A 5-week-old male presented with jaundice. Physical examination revealed an alert but deeply icteric infant. Laboratory data demonstrated direct hyperbilirubinemia, a severely deranged coagulation profile, normal transaminase, and normal ammonia. Magnetic resonance imaging of the abdomen was suggestive of perinatal hemochromatosis. Liver biopsy showed histiocytic infiltration with an absence of hepatocytes. No hemosiderin deposition was identified in a buccal mucosa biopsy. CONCLUSION Neonatal liver failure in the absence of hepatocellular regeneration potentially reflects an acquired or inborn defect in the regulation of hepatic regeneration.
背景 急性暴发性肝衰竭很少发生在新生儿期。病因包括病毒感染(15%)、代谢/遗传疾病(10%)、血液病(15%)和缺血性损伤(5%)。妊娠同种免疫性肝病通常表现为严重的新生儿肝功能衰竭,伴有广泛的肝脏和肝脏外铁负荷过重,网状内皮系统幸免于难。空肝衰竭是一种罕见的肝衰竭病因,患者在新生儿期出现肝衰竭,但肝活检中没有肝细胞。病例摘要 一名 5 周大的男性患者出现黄疸。体格检查显示婴儿神志清醒,但深度黄疸。实验室数据显示为直接高胆红素血症,凝血功能严重失常,转氨酶正常,氨氮正常。腹部磁共振成像提示围产期血色素沉着病。肝脏活检显示有组织细胞浸润,但没有肝细胞。口腔粘膜活检未发现血色素沉积。结论 新生儿肝功能衰竭且无肝细胞再生,可能反映了后天或先天性肝再生调节缺陷。
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引用次数: 0
Gut microbiota in preterm infants receiving breast milk or mixed feeding 母乳喂养或混合喂养早产儿的肠道微生物群
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.90499
S. Sánchez-González, Bárbara Gabriela Cárdenas-del-Castillo, Elvira Garza-González, Gerardo R Padilla-Rivas, Isaías Rodríguez-Balderrama, C. Treviño‐Garza, F. Montes-Tapia, Gerardo C Palacios-Saucedo, Anthony Gutiérrez-Rodríguez, M. de-la-O-Cavazos
BACKGROUND Preterm birth is the leading cause of mortality in newborns, with very-low-birth-weight infants usually experiencing several complications. Breast milk is considered the gold standard of nutrition, especially for preterm infants with delayed gut colonization, because it contains beneficial microorganisms, such as Lactobacilli and Bifidobacteria . AIM To analyze the gut microbiota of breastfed preterm infants with a birth weight of 1500 g or less. METHODS An observational study was performed on preterm infants with up to 36.6 wk of gestation and a birth weight of 1500 g or less, born at the University Hospital Dr. José Eleuterio González at Monterrey, Mexico. A total of 40 preterm neonates were classified into breast milk feeding (BM) and mixed feeding (MF) groups (21 in the BM group and 19 in the MF group), from October 2017 to June 2019. Fecal samples were collected before they were introduced to any feeding type. After full enteral feeding was achieved, the composition of the gut microbiota was analyzed using 16S rRNA gene sequencing. Numerical variables were compared using Student’s t -test or using the Mann–Whitney U test for nonparametric variables. Dominance, evenness, equitability, Margalef’s index, Fisher’s alpha, Chao-1 index, and Shannon’s diversity index were also calculated. RESULTS No significant differences were observed at the genus level between the groups. Class comparison indicated higher counts of Alphaproteobacteria and Betaproteobacteria in the initial compared to the final sample of the BM group (P < 0.011). In addition, higher counts of Gammaproteobacteria were detected in the final than in the initial sample (P = 0.040). According to the Margalef index, Fisher’s alpha, and Chao-1 index, a decrease in species richness from the initial to the final sample, regardless of the feeding type, was observed (P < 0.050). The four predominant phyla were Bacteroidetes, Actinobacteria, Firmicutes , and Proteobacteria, with Proteobacteria being the most abundant. However, no significant differences were observed between the initial and final samples at the phylum level. CONCLUSION Breastfeeding is associated with a decrease in Alphaproteobacteria and Betaproteobacteria and an increase of Gammaproteobacteria , contributing to the literature of the gut microbiota structure of very low-birth-weight, preterm.
背景早产是新生儿死亡的主要原因,超低出生体重儿通常会出现多种并发症。母乳被认为是营养的黄金标准,尤其是对于肠道定植延迟的早产儿,因为母乳中含有乳酸杆菌和双歧杆菌等有益微生物。目的 分析出生体重在 1500 克或以下的母乳喂养早产儿的肠道微生物群。方法 对墨西哥蒙特雷 José Eleuterio González 博士大学医院出生的妊娠期不超过 36.6 周、出生体重不超过 1500 克的早产儿进行观察研究。2017年10月至2019年6月期间,共有40名早产新生儿被分为母乳喂养(BM)组和混合喂养(MF)组(母乳喂养组21人,混合喂养组19人)。在采用任何喂养方式之前,均采集了粪便样本。在实现完全肠内喂养后,使用 16S rRNA 基因测序分析了肠道微生物群的组成。数字变量的比较采用学生 t 检验,非参数变量的比较采用 Mann-Whitney U 检验。还计算了优势度、均匀度、均等度、Margalef 指数、Fisher's α、Chao-1 指数和香农多样性指数。结果 各组之间在属一级未发现明显差异。类比较显示,与 BM 组的最终样本相比,Alphaproteobacteria 和 Betaproteobacteria 在初始样本中的数量较多(P < 0.011)。此外,最终样本中检测到的 Gammaproteobacteria 数量也高于初始样本(P = 0.040)。根据 Margalef 指数、Fisher's α 指数和 Chao-1 指数,从初始样本到最终样本,无论喂养类型如何,物种丰富度均有所下降(P < 0.050)。最主要的四个门类是类杆菌科、放线菌科、固着菌科和变形菌科,其中变形菌科的物种最为丰富。然而,初始样本和最终样本在门的水平上没有观察到明显的差异。结论 母乳喂养与Alphaproteobacteria和Betaproteobacteria的减少以及Gammaproteobacteria的增加有关,这有助于研究超低出生体重早产儿的肠道微生物群结构。
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引用次数: 0
Type 2 diabetes in children and adolescents: Exploring the disease heterogeneity and research gaps to optimum management 儿童和青少年的 2 型糖尿病:探索疾病的异质性和研究空白,实现最佳管理
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.91587
Subhodip Pramanik, Sunetra Mondal, Rajan Palui, Sayantan Ray
Over the past 20 years, the incidence and prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents have increased, particularly in racial and ethnic minorities. Despite the rise in T2DM in children and adolescents, the pathophysiology and progression of disease in this population are not clearly understood. Youth-onset T2DM has a more adverse clinical course than is seen in those who develop T2DM in adulthood or those with T1DM. Furthermore, the available therapeutic options are more limited for children and adolescents with T2DM compared to adult patients, mostly due to the challenges of implementing clinical studies. A better understanding of the mechanisms underlying the de-velopment and aggressive disease phenotype of T2DM in youth is important to finding effective prevention and management strategies. This review highlights the key evidence about T2DM in children and adolescents and its current burden and challenges both in clinical care and research activities.
过去 20 年来,儿童和青少年中 2 型糖尿病(T2DM)的发病率和流行率不断上升,尤其是在少数种族和少数民族中。尽管儿童和青少年 T2DM 的发病率有所上升,但人们对这一人群的病理生理学和疾病进展还没有清楚的认识。与成年后患 T2DM 或 T1DM 的患者相比,青少年患 T2DM 的临床病程更为不利。此外,与成年患者相比,儿童和青少年 T2DM 患者的可用治疗方案更为有限,这主要是由于开展临床研究所面临的挑战。要找到有效的预防和管理策略,就必须更好地了解青少年 T2DM 的发病机制和侵袭性疾病表型。本综述重点介绍了有关儿童和青少年 T2DM 的主要证据,以及其目前在临床治疗和研究活动中的负担和挑战。
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引用次数: 0
Metabolomic changes in children with autism 自闭症儿童代谢组的变化
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.92737
Mohammed Al-Beltagi, N. Saeed, A. Bediwy, Reem Elbeltagi
BACKGROUND Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors. Metabolomic profiling has emerged as a valuable tool for understanding the underlying metabolic dysregulations associated with ASD. AIM To comprehensively explore metabolomic changes in children with ASD, integrating findings from various research articles, reviews, systematic reviews, meta-analyses, case reports, editorials, and a book chapter. METHODS A systematic search was conducted in electronic databases, including PubMed, PubMed Central, Cochrane Library, Embase, Web of Science, CINAHL, Scopus, LISA, and NLM catalog up until January 2024. Inclusion criteria encompassed research articles (83), review articles (145), meta-analyses (6), systematic reviews (6), case reports (2), editorials (2), and a book chapter (1) related to metabolomic changes in children with ASD. Exclusion criteria were applied to ensure the relevance and quality of included studies. RESULTS The systematic review identified specific metabolites and metabolic pathways showing consistent differences in children with ASD compared to typically developing individuals. These metabolic biomarkers may serve as objective measures to support clinical assessments, improve diagnostic accuracy, and inform personalized treatment approaches. Metabolomic profiling also offers insights into the metabolic alterations associated with comorbid conditions commonly observed in individuals with ASD. CONCLUSION Integration of metabolomic changes in children with ASD holds promise for enhancing diagnostic accuracy, guiding personalized treatment approaches, monitoring treatment response, and improving outcomes. Further research is needed to validate findings, establish standardized protocols, and overcome technical challenges in metabolomic analysis. By advancing our understanding of metabolic dysregulations in ASD, clinicians can improve the lives of affected individuals and their families.
背景自闭症谱系障碍(ASD)是一种神经发育疾病,其特征是社交沟通和重复行为方面的缺陷。代谢组学分析已成为了解与自闭症谱系障碍相关的潜在代谢失调的重要工具。目的 综合各种研究文章、综述、系统综述、荟萃分析、病例报告、社论和一本书的章节,全面探讨 ASD 儿童代谢组的变化。方法 在电子数据库中进行了系统性检索,包括 PubMed、PubMed Central、Cochrane Library、Embase、Web of Science、CINAHL、Scopus、LISA 和 NLM 目录(截至 2024 年 1 月)。纳入标准包括与 ASD 儿童代谢组变化相关的研究文章(83 篇)、综述文章(145 篇)、荟萃分析(6 篇)、系统综述(6 篇)、病例报告(2 篇)、社论(2 篇)和书籍章节(1 篇)。为确保纳入研究的相关性和质量,采用了排除标准。结果 系统综述确定了特定的代谢物和代谢途径,这些代谢物和途径在 ASD 儿童与发育正常的个体之间显示出一致的差异。这些代谢生物标志物可作为支持临床评估的客观指标,提高诊断准确性,并为个性化治疗方法提供依据。代谢组学分析还有助于深入了解与 ASD 患儿常见合并症相关的代谢改变。结论 整合 ASD 儿童的代谢组变化有望提高诊断准确性、指导个性化治疗方法、监测治疗反应并改善预后。还需要进一步的研究来验证研究结果、建立标准化方案并克服代谢组分析中的技术挑战。通过增进我们对 ASD 代谢失调的了解,临床医生可以改善患者及其家人的生活。
{"title":"Metabolomic changes in children with autism","authors":"Mohammed Al-Beltagi, N. Saeed, A. Bediwy, Reem Elbeltagi","doi":"10.5409/wjcp.v13.i2.92737","DOIUrl":"https://doi.org/10.5409/wjcp.v13.i2.92737","url":null,"abstract":"BACKGROUND\u0000 Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by deficits in social communication and repetitive behaviors. Metabolomic profiling has emerged as a valuable tool for understanding the underlying metabolic dysregulations associated with ASD.\u0000 AIM\u0000 To comprehensively explore metabolomic changes in children with ASD, integrating findings from various research articles, reviews, systematic reviews, meta-analyses, case reports, editorials, and a book chapter.\u0000 METHODS\u0000 A systematic search was conducted in electronic databases, including PubMed, PubMed Central, Cochrane Library, Embase, Web of Science, CINAHL, Scopus, LISA, and NLM catalog up until January 2024. Inclusion criteria encompassed research articles (83), review articles (145), meta-analyses (6), systematic reviews (6), case reports (2), editorials (2), and a book chapter (1) related to metabolomic changes in children with ASD. Exclusion criteria were applied to ensure the relevance and quality of included studies.\u0000 RESULTS\u0000 The systematic review identified specific metabolites and metabolic pathways showing consistent differences in children with ASD compared to typically developing individuals. These metabolic biomarkers may serve as objective measures to support clinical assessments, improve diagnostic accuracy, and inform personalized treatment approaches. Metabolomic profiling also offers insights into the metabolic alterations associated with comorbid conditions commonly observed in individuals with ASD.\u0000 CONCLUSION\u0000 Integration of metabolomic changes in children with ASD holds promise for enhancing diagnostic accuracy, guiding personalized treatment approaches, monitoring treatment response, and improving outcomes. Further research is needed to validate findings, establish standardized protocols, and overcome technical challenges in metabolomic analysis. By advancing our understanding of metabolic dysregulations in ASD, clinicians can improve the lives of affected individuals and their families.","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":" 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141368000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity: Implications for prevention and intervention 评估摩洛哥医生关于产妇肥胖对儿童肥胖影响的知识和做法:预防和干预的意义
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.91255
Imane Douiyeh, Jihane Khamlich, Naima Nabih, A. Saih, Ilham Boumendil, Anas Regragui, A. Kettani, Amal Safi
BACKGROUND Childhood obesity is a growing global concern with far-reaching health implications. This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity. Despite the increasing prevalence of childhood obesity worldwide, this issue remains inadequately addressed in the Moroccan context. AIM To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity. METHODS The research encompasses a comprehensive survey of practicing physicians, revealing significant gaps in awareness and practices related to maternal obesity. RESULTS Notably, a significant portion of doctors do not provide adequate guidance to overweight pregnant women, highlighting the urgency for targeted educational programs. CONCLUSION In conclusion, this research illuminates critical areas for improvement in tackling childhood obesity in Morocco. By addressing these gaps, fostering awareness, and enhancing medical practices, the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.
背景 儿童肥胖症是全球日益关注的问题,对健康影响深远。本研究的重点是评估摩洛哥医生对孕产妇肥胖与儿童肥胖之间联系的认识和做法。尽管儿童肥胖症在全球范围内日益普遍,但在摩洛哥,这一问题仍未得到充分解决。目的 评估摩洛哥医生对孕产妇肥胖与儿童肥胖之间联系的认识和做法。方法 该研究包括对执业医师的全面调查,揭示了在有关孕产妇肥胖的认识和实践方面存在的巨大差距。结果 值得注意的是,相当一部分医生没有为超重孕妇提供足够的指导,这凸显了有针对性的教育计划的紧迫性。结论 总之,这项研究揭示了摩洛哥在解决儿童肥胖问题方面需要改进的关键领域。通过弥补这些不足、提高认识和加强医疗实践,医疗保健系统可以为预防儿童肥胖症和改善后代的整体健康做出重大贡献。
{"title":"Assessing Moroccan physician knowledge and practices regarding maternal obesity's impact on childhood obesity: Implications for prevention and intervention","authors":"Imane Douiyeh, Jihane Khamlich, Naima Nabih, A. Saih, Ilham Boumendil, Anas Regragui, A. Kettani, Amal Safi","doi":"10.5409/wjcp.v13.i2.91255","DOIUrl":"https://doi.org/10.5409/wjcp.v13.i2.91255","url":null,"abstract":"BACKGROUND\u0000 Childhood obesity is a growing global concern with far-reaching health implications. This study focuses on evaluating the knowledge and practices of physicians in Morocco regarding the link between maternal obesity and childhood obesity. Despite the increasing prevalence of childhood obesity worldwide, this issue remains inadequately addressed in the Moroccan context.\u0000 AIM\u0000 To assess the awareness and practices of physicians in Morocco concerning the connection between maternal obesity and childhood obesity.\u0000 METHODS\u0000 The research encompasses a comprehensive survey of practicing physicians, revealing significant gaps in awareness and practices related to maternal obesity.\u0000 RESULTS\u0000 Notably, a significant portion of doctors do not provide adequate guidance to overweight pregnant women, highlighting the urgency for targeted educational programs.\u0000 CONCLUSION\u0000 In conclusion, this research illuminates critical areas for improvement in tackling childhood obesity in Morocco. By addressing these gaps, fostering awareness, and enhancing medical practices, the healthcare system can contribute significantly to preventing childhood obesity and improving the overall health of future generations.","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":" 80","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141367510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prediabetes in children and adolescents: A ticking bomb! 儿童和青少年的糖尿病前期:一颗定时炸弹!
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.92127
Anju Gupta, Nitin Choudhary, N. Gupta
Prediabetes in children and adolescents is on the rise which has drawn significant attention over the past decade. It is an early warning sign of the underlying pathophysiological changes which in due course of time might compound into type II diabetes mellitus. The incidence of prediabetes in adolescents ranges from 4%-23% which is alarmingly high and requires active intervention from the system. We have discussed early identification of high-risk patients, prompt screening and active intervention to manage this growing problem.
儿童和青少年的糖尿病前期呈上升趋势,在过去十年中引起了人们的极大关注。它是潜在病理生理变化的早期预警信号,随着时间的推移,可能会发展成 II 型糖尿病。青少年糖尿病前期的发病率为 4%-23%,高得惊人,需要系统的积极干预。我们讨论了早期识别高危患者、及时筛查和积极干预以应对这一日益严重的问题。
{"title":"Prediabetes in children and adolescents: A ticking bomb!","authors":"Anju Gupta, Nitin Choudhary, N. Gupta","doi":"10.5409/wjcp.v13.i2.92127","DOIUrl":"https://doi.org/10.5409/wjcp.v13.i2.92127","url":null,"abstract":"Prediabetes in children and adolescents is on the rise which has drawn significant attention over the past decade. It is an early warning sign of the underlying pathophysiological changes which in due course of time might compound into type II diabetes mellitus. The incidence of prediabetes in adolescents ranges from 4%-23% which is alarmingly high and requires active intervention from the system. We have discussed early identification of high-risk patients, prompt screening and active intervention to manage this growing problem.","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141367951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mast cell activation syndrome: An up-to-date review of literature 肥大细胞活化综合征:最新文献综述
Pub Date : 2024-06-09 DOI: 10.5409/wjcp.v13.i2.92813
Öner Özdemir, Gökçe Kasımoğlu, Ayşegül Bak, Hüseyin Sütlüoğlu, Süreyya Savaşan
Mast cells are a subtype of white blood cells and are involved in the immune system. These cells contain many chemical substances called mediators, which are involved in the allergic response. The fact that mast cells play a role in many events that require urgent intervention, especially anaphylaxis, has led to a more detailed study of these cells. The diseases also caused by dysfunctions of mast cells have been examined in many circumstances. For instance, mast cell activation syndrome is known as an augmented number of cells due to decreased cell death, resulting in clinical symptoms affecting many systems. The main common symptoms include flushing, hypotension, urticaria, angioedema, headache, vomiting and diarrhea. Although the underlying mechanism is not yet clearly known, we aim to review the literature in a broad perspective and bring together the existing knowledge in the light of the literature due to the diversity of its involvement in the body and the fact that it is a little known syndrome.
肥大细胞是白细胞的一种亚型,参与免疫系统。这些细胞含有许多称为介质的化学物质,参与过敏反应。事实上,肥大细胞在许多需要紧急干预的事件(尤其是过敏性休克)中发挥着作用,这促使人们对这些细胞进行更详细的研究。在许多情况下,肥大细胞功能障碍也会导致疾病。例如,肥大细胞活化综合征就是由于细胞死亡减少导致细胞数量增加,从而出现影响多个系统的临床症状。常见的主要症状包括潮红、低血压、荨麻疹、血管性水肿、头痛、呕吐和腹泻。尽管其基本机制尚未明确,但由于其在人体中的参与具有多样性,而且是一种鲜为人知的综合征,因此我们旨在从广阔的视角对文献进行回顾,并根据文献汇集现有的知识。
{"title":"Mast cell activation syndrome: An up-to-date review of literature","authors":"Öner Özdemir, Gökçe Kasımoğlu, Ayşegül Bak, Hüseyin Sütlüoğlu, Süreyya Savaşan","doi":"10.5409/wjcp.v13.i2.92813","DOIUrl":"https://doi.org/10.5409/wjcp.v13.i2.92813","url":null,"abstract":"Mast cells are a subtype of white blood cells and are involved in the immune system. These cells contain many chemical substances called mediators, which are involved in the allergic response. The fact that mast cells play a role in many events that require urgent intervention, especially anaphylaxis, has led to a more detailed study of these cells. The diseases also caused by dysfunctions of mast cells have been examined in many circumstances. For instance, mast cell activation syndrome is known as an augmented number of cells due to decreased cell death, resulting in clinical symptoms affecting many systems. The main common symptoms include flushing, hypotension, urticaria, angioedema, headache, vomiting and diarrhea. Although the underlying mechanism is not yet clearly known, we aim to review the literature in a broad perspective and bring together the existing knowledge in the light of the literature due to the diversity of its involvement in the body and the fact that it is a little known syndrome.","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":" 47","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141368381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Gut microbiota predicts the diagnosis of ulcerative colitis in Saudi children 肠道微生物群可预测沙特儿童溃疡性结肠炎的诊断结果
Pub Date : 2024-03-09 DOI: 10.5409/wjcp.v13.i1.90755
M. E. El Mouzan, Ahmed A. Al Sarkhy, Asaad Assiri
BACKGROUND Ulcerative colitis (UC) is an immune-mediated chronic inflammatory condition with a worldwide distribution. Although the etiology of this disease is still unknown, the understanding of the role of the microbiota is becoming increasingly strong. AIM To investigate the predictive power of the gut microbiota for the diagnosis of UC in a cohort of newly diagnosed treatment-naïve Saudi children with UC. METHODS The study population included 20 children with a confirmed diagnosis of UC and 20 healthy controls. Microbial DNA was extracted and sequenced, and shotgun metagenomic analysis was performed for bacteria and bacteriophages. Biostatistics and bioinformatics demonstrated significant dysbiosis in the form of reduced alpha diversity, beta diversity, and significant difference of abundance of taxa between children with UC and control groups. The receiver operating characteristic curve, a probability curve, was used to determine the difference between the UC and control groups. The area under the curve (AUC) represents the degree of separability between the UC group and the control group. The AUC was calculated for all identified bacterial species and for bacterial species identified by the random forest classification algorithm as important potential biomarkers of UC. A similar method of AUC calculation for all bacteriophages and important species was used. RESULTS The median age and range were 14 (0.5-21) and 12.9 (6.8-16.3) years for children with UC and controls, respectively, and 40% and 35% were male for children with UC and controls, respectively. The AUC for all identified bacterial species was 89.5%. However, when using the bacterial species identified as important by random forest classification algorithm analysis, the accuracy increased to 97.6%. Similarly, the AUC for all the identified bacteriophages was 87.4%, but this value increased to 94.5% when the important bacteriophage biomarkers were used. CONCLUSION The very high to excellent AUCs of fecal bacterial and viral species suggest the potential use of noninvasive microbiota-based tests for the diagnosis of unusual cases of UC in children. In addition, the identification of important bacteria and bacteriophages whose abundance is reduced in children with UC suggests the potential of preventive and adjuvant microbial therapy for UC.
背景溃疡性结肠炎(UC)是一种免疫介导的慢性炎症,分布于世界各地。虽然这种疾病的病因尚不清楚,但人们对微生物群的作用的认识却越来越深刻。目的 在一组新诊断的未经治疗的沙特 UC 儿童中,研究肠道微生物群对 UC 诊断的预测能力。方法 研究对象包括 20 名确诊为 UC 的儿童和 20 名健康对照组。对微生物 DNA 进行了提取和测序,并对细菌和噬菌体进行了枪式元基因组分析。生物统计学和生物信息学结果表明,UC 患儿与对照组之间存在明显的菌群失调,表现为α多样性和β多样性降低,类群丰度存在显著差异。接受者操作特征曲线(一种概率曲线)用于确定 UC 组和对照组之间的差异。曲线下面积(AUC)表示 UC 组与对照组之间的可分离性程度。AUC 是针对所有已确定的细菌种类以及通过随机森林分类算法确定为 UC 重要潜在生物标记物的细菌种类计算的。对所有噬菌体和重要菌种也采用了类似的 AUC 计算方法。结果 UC患儿和对照组患儿的中位年龄和范围分别为14(0.5-21)岁和12.9(6.8-16.3)岁,UC患儿和对照组患儿的男性比例分别为40%和35%。所有鉴定出的细菌种类的AUC为89.5%。然而,当使用随机森林分类算法分析确定的重要细菌种类时,准确率提高到了 97.6%。同样,所有鉴定出的噬菌体的 AUC 为 87.4%,但当使用重要的噬菌体生物标记物时,该值增至 94.5%。结论 粪便中细菌和病毒种类的AUC非常高甚至非常好,这表明基于微生物群的无创检验有可能用于儿童UC异常病例的诊断。此外,鉴定出 UC 患儿体内丰度降低的重要细菌和噬菌体表明,有可能对 UC 进行预防性和辅助性微生物治疗。
{"title":"Gut microbiota predicts the diagnosis of ulcerative colitis in Saudi children","authors":"M. E. El Mouzan, Ahmed A. Al Sarkhy, Asaad Assiri","doi":"10.5409/wjcp.v13.i1.90755","DOIUrl":"https://doi.org/10.5409/wjcp.v13.i1.90755","url":null,"abstract":"BACKGROUND\u0000 Ulcerative colitis (UC) is an immune-mediated chronic inflammatory condition with a worldwide distribution. Although the etiology of this disease is still unknown, the understanding of the role of the microbiota is becoming increasingly strong.\u0000 AIM\u0000 To investigate the predictive power of the gut microbiota for the diagnosis of UC in a cohort of newly diagnosed treatment-naïve Saudi children with UC.\u0000 METHODS\u0000 The study population included 20 children with a confirmed diagnosis of UC and 20 healthy controls. Microbial DNA was extracted and sequenced, and shotgun metagenomic analysis was performed for bacteria and bacteriophages. Biostatistics and bioinformatics demonstrated significant dysbiosis in the form of reduced alpha diversity, beta diversity, and significant difference of abundance of taxa between children with UC and control groups. The receiver operating characteristic curve, a probability curve, was used to determine the difference between the UC and control groups. The area under the curve (AUC) represents the degree of separability between the UC group and the control group. The AUC was calculated for all identified bacterial species and for bacterial species identified by the random forest classification algorithm as important potential biomarkers of UC. A similar method of AUC calculation for all bacteriophages and important species was used.\u0000 RESULTS\u0000 The median age and range were 14 (0.5-21) and 12.9 (6.8-16.3) years for children with UC and controls, respectively, and 40% and 35% were male for children with UC and controls, respectively. The AUC for all identified bacterial species was 89.5%. However, when using the bacterial species identified as important by random forest classification algorithm analysis, the accuracy increased to 97.6%. Similarly, the AUC for all the identified bacteriophages was 87.4%, but this value increased to 94.5% when the important bacteriophage biomarkers were used.\u0000 CONCLUSION\u0000 The very high to excellent AUCs of fecal bacterial and viral species suggest the potential use of noninvasive microbiota-based tests for the diagnosis of unusual cases of UC in children. In addition, the identification of important bacteria and bacteriophages whose abundance is reduced in children with UC suggests the potential of preventive and adjuvant microbial therapy for UC.","PeriodicalId":75338,"journal":{"name":"World journal of clinical pediatrics","volume":"154 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sociodemographic determinants associated with breastfeeding in term infants with low birth weight in Latin American countries 与拉丁美洲国家出生体重不足的足月婴儿母乳喂养有关的社会人口决定因素
Pub Date : 2024-03-09 DOI: 10.5409/wjcp.v13.i1.89086
C. J. Avendaño-Vásquez, Magda Liliana Villamizar-Osorio, Claudia Jazmin Niño-Peñaranda, Judith Medellín-Olaya, Nadia Carolina Reina-Gamba
BACKGROUND A progressive decrease in exclusive breastfeeding (BF) is observed in Latin America and the Caribbean compared with global results. The possibility of being breastfed and continuing BF for > 6 months is lower in low birth weight than in healthy-weight infants. AIM To identify factors associated with BF maintenance and promotion, with particular attention to low- and middle-income countries, by studying geographic, socioeconomic, and individual or neonatal health factors. METHODS A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States. The extracted data with common characteristics were synthesized and categorized into two main themes: (1) Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America; and (2) individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants. RESULTS This study identified maternal age, educational level, maternal economic capacity, social stratum, exposure to BF substitutes, access to BF information, and quality of health services as mediators for maintaining BF. CONCLUSION Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.
背景:与全球结果相比,拉丁美洲和加勒比地区的纯母乳喂养率逐渐下降。出生体重低的婴儿接受母乳喂养并持续 6 个月以上的可能性低于体重健康的婴儿。目的 通过研究地理、社会经济、个人或新生儿健康因素,确定与维持和促进母乳喂养相关的因素,尤其关注中低收入国家。方法 采用美国公平与健康不平等委员会发布的健康社会决定因素概念模型,于 2018 年进行了范围综述。对提取的具有共同特征的数据进行了综合,并将其归类为两大主题:(1)拉丁美洲低出生体重足月婴儿开始和维持母乳喂养所涉及的社会人口因素和近端决定因素;(2)与低出生体重足月婴儿维持和坚持母乳喂养的自我效能能力相关的个体特征。结果 该研究发现,产妇年龄、教育水平、产妇经济能力、社会阶层、母乳喂养替代品的接触、母乳喂养信息的获取以及医疗服务质量是维持母乳喂养的中介因素。结论 应分析高危人群坚持母乳喂养的个人自我效能因素,以获得更好的健康结果。
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World journal of clinical pediatrics
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