Articles

Objective: This case series describes the presentation, clinical course, and functional outcomes of four pediatric patients with neuroinvasive Powassan virus infection who were admitted to inpatient rehabilitation with severe neurologic impairments. Design/Methods: Retrospective case series. Results: Inpatient rehabilitation treatment resulted in functional improvement across all patients with the most consistent gains noted in cognitive functions, including comprehension and social interaction. 

In pediatric medicine, the most powerful stories often arise not from common conditions, but from the outliers—the children whose clinical constellations challenge what we think we know about inheritance, phenotype, and disease mechanisms. The report in this issue of Pediatrics describes one such case: a 6-year-old boy presenting with multiple osteochondromas, short stature, and dysmorphic features, in whom next-generation sequencing revealed a single heterozygous pathogenic variant in SMARCAL1, the gene classically associated with Schimke immuno-osseous dysplasia (SIOD). 

Objective: To explore the safety and clinical efficacy of using the ultrasonic bone scalpel (UBS) system for laminectomy, osteotomy of posterior longitudinal ligament (PLL) ossification, combined with correction of kyphosis deformity in the treatment of multilevel thoracic ossification of the PLL. Methods: A retrospective analysis was conducted on patients with multilevel thoracic ossification of the PLL who underwent laminectomy, osteotomy of PLL ossification, combined with correction of kyphosis deformity using the UBS system from January 2020 to April 2023. 

Introduction: Hypertension (HTN) is a major public health issue and is both a cause and a common complication of chronic kidney disease (CKD). This study aimed to determine the prevalence of HTN and identify its associated factors in patients with advanced CKD in Parakou, Benin. Patients and Methods: A cross-sectional study was conducted in the Nephrology Department of the CHUD-B/A hospital from April 01, 2023, to August 31, 2023. We included all consenting patients aged 15 and over with stage 3 to 5 CKD. 

Acute gout flares cause severe pain, and conventional therapies are often contraindicated. Interleukin-1 (IL-1) inhibitors offer a targeted mechanism, but their efficacy and safety profile require systematic evaluation. This PRISMA-adherent systematic review and meta-analysis of 10 randomized controlled trials (n=1,731) assessed the efficacy and safety of IL-1 inhibitors (anakinra, canakinumab, rilonacept) versus active comparators or placebo.

Metabolic diseases such as hypertension, obesity, diabetes, and vascular disorders have reached epidemic proportions worldwide [1–6]. Despite major advances in medicine, cardiovascular disease has remained the leading cause of death for more than a century. Among these disorders, diabetes mellitus stands out as a major contributor to morbidity and mortality, placing a heavy burden on patients, healthcare systems, and economies. 

This commentary addresses two distinct aspects of autism spectrum condition. First, it critiques the proposed link between fetal testosterone levels and the emergence of autistic traits, arguing that such theories are reductive and risk overshadowing the profound heterogeneity and individuality of autistic people. The author suggests a more limited, theoretical connection between testosterone-driven neural development and a higher incidence of STEM savant skills in some autistic individuals.

Contrast-induced acute kidney injury (CI-AKI) is a potential complication following percutaneous coronary intervention (PCI), particularly in patients with pre-existing kidney conditions. Previous research has identified hyperuricemia as a predictor for CI-AKI. Allopurinol, a medication commonly used to manage hyperuricemia, also possesses anti-inflammatory properties. This study aims to assess the impact of adding allopurinol to hydration therapy on CI-AKI incidence in patients undergoing PCI.

Immunotherapy, particularly immune checkpoint inhibitors (ICIs), has revolutionized cancer treatment by harnessing the host immune system to target malignancies. Melanoma, head and neck squamous cell carcinoma (HNSCC), and triple-negative breast cancer (TNBC) were among the first solid tumors to gain regulatory approval for ICIs due to their immunogenicity and unmet clinical needs. Melanoma exemplifies the success of ICI therapy, with durable responses driven by its high mutation burden and neoantigen landscape, yet both primary and acquired resistance remain major challenges. 

Vitamin B12 (cobalamin) is an essential micronutrient involved in DNA synthesis, erythropoiesis, and neurological function. Deficiency can result in hematological, neurological, and psychiatric manifestations, potentially leading to severe and irreversible complications if untreated. This editorial reviews current therapeutic strategies for vitamin B12 deficiency, including conventional supplementation forms, recommended dosages, and treatment durations. 

Breast cancer remains the most frequently diagnosed malignancy in women worldwide. TNBC—defined by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2)—comprises ~15–20% of cases and is disproportionately represented among younger women, women of African ancestry, and carriers of germline BRCA1 mutations.

Influenza and other seasonal respiratory viruses affect millions annually. While age is generally known to be correlated with risk and outcome, the mechanisms underlying thesedifferences, especially in the infected, have been poorly defined. Previous studies have focused primarily on cell-subset shifts in older adults, leaving a gap in understanding of how cytokine responses vary across the full age spectrum.

Chronic Spontaneous Urticaria (CSU) is a multifactorial disease with an incompletely understood etiology. COVID-19 vaccines can influence the immune system. This study evaluates the risk factors and comorbidities associated with CSU in patients who developed CSU following COVID-19 vaccination or infection.

Male involvement in sexual and reproductive health (SRH) is increasingly recognized as a crucial factor for improving maternal, neonatal, and family well-being. This paper shares personal, peer, and community experiences from Nepal, highlighting both the benefits and barriers to men’s engagement in SRH. 

Esophageal cancer, a highly aggressive malignancy, frequently presents with advanced-stage dysphagia, significantly impacting patient quality of life. While surgical resection offers the best chance for cure in early stages, many patients are diagnosed with unresectable or metastatic disease, necessitating palliative interventions to alleviate symptoms.

Aim: This study evaluates the sociodemographic, clinical, and anthropometric data of infants diagnosed with Food Protein-Induced Allergic Proctocolitis (FPIAP), categorized as exclusively breastfeeding or formula feeding at the onset of symptoms. This division allows us to compare the effects of different feeding on the development of FPIAP. Methods: This retrospective, observational, single-center study included infants ≤36 months diagnosed with FPIAP. Exclusion criteria were chronic morbidities to ensure a focused study population. 

Undifferentiated embryonal sarcoma of the liver (UESL) is an uncommon malignant neoplasm in the pediatric population, accounting for a small fraction of primary hepatic tumors but associated with an aggressive clinical course and poor prognosis. Surgical resection remains the mainstay of treatment; however, extended hepatectomy can leave patients with limited functional reserve and predispose them to hepatic failure, making liver transplantation (LT) a therapeutic alternative in selected cases.

Congenital diaphragmatic hernia (CDH) is a developmental defect of the diaphragm, occurring in approximately 1 in 3,000 live births with a high mortality rate of between 30 and 50%. This narrative review provides an update on antenatal and postnatal management strategies and current outcomes emphasizing where further research is required. Fetal endotracheal obstruction (FETO) has been demonstrated in a large RCT to improve survival in the most severe CDH and is now adopted into clinical practice.

Both asthma and periodontitis are multifactorial and highly prevalent with global burden chronic diseases sharing similar genetic, environmental, infectious, and inflammatory factors. The first attempts to study the relationship between asthma and periodontal diseases started in the 1970s and continued till now a days. 

Antibiotics play an important role in both the prophylaxis and treatment of infectious diseases and are a cornerstone of modern healthcare. Antibiotics are lifesaving medicines and have enabled many advances in modern medicine. However, the more they are used, the less effective they become. Thus, the issues of their availability, selection, and appropriate use are of critical importance to the global community.