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Original Article
Gastroenterology
Thyroid disturbances in children treated with combined pegylated interferon-alpha and ribavirin for chronic hepatitis C
Yasser K. Rashed, Fatma A. Khalaf, Sobhy E. Kotb
Clin Exp Pediatr. 2020;63(2):52-55.   Published online September 27, 2019
Background: Immunomodulatory properties of interferon (IFN) have been documented. It may induce autoimmune diseases such as autoimmune thyroiditis with hypo- or hyperthyroidism. In addition, it may impair thyroid hormone synthesis through affecting iodide organification in thyroid gland.
Purpose: The aim of this study was to describe thyroid function tests disturbances in children with chronic hepatitis C (CHC) receiving pegylated interferon-alpha (PEG...
Neonatology (Perinatology)
Placental histopathology in late preterm infants: clinical implications
Kristina Ericksen, Joshua Fogel, Rita P. Verma
Clin Exp Pediatr. 2020;63(2):48-51.   Published online August 19, 2019
Question: Placental histopathology and its clinical implications in late preterm infants.
Finding: Placental vascular anomalies are more, and placental inflammation less common in late preterm infants compared to term. Higher maternal age, magnesium sulfate therapy and hypertension are clinical risk factors associated with late preterm delivery.
Meaning: Prevention and aggressive management of hypertension, and conception before 30 years of age might be effective in preventing late preterm births.
Effectiveness of various nonpharmacological analgesic methods in newborns
Pancham Kumar, Rakesh Sharma, Sukhdev Rathour, Sunidhi Karol, Mohit Karol
Clin Exp Pediatr. 2020;63(1):25-29.   Published online August 16, 2019
Question: Can nonpharmacological methods be used for neonatal pain management.
Finding: Nonpharmacological methods like Sucrose, breastfeeding etc have shown to significantly reduce the pain caused by intramuscular hepatitis B vaccination.
Meaning: Nonpharmacological methods are the safe and cheap potential modalities of analgesia which can be used during mild to moderate pain in newborns.
Critical Care Medicine
Comparative validity of microalbuminuria versus clinical mortality scores to predict pediatric intensive care unit outcomes
Shifa Nismath, Suchetha S. Rao, B.S. Baliga, Vaman Kulkarni, Gayatri M. Rao
Clin Exp Pediatr. 2020;63(1):20-24.   Published online August 12, 2019
Question: Does microalbuminuria predict mortality in pediatric intensive care unit?
Finding: Positive correlation was found between albumin-creatinine ratio and pediatric intensive care unit stay, organ dysfunction and need of inotropes. Area under the receiver operating characteristic curve for albumin-creatinine ratio was comparable to mortality scores.
Meaning: Microalbuminuria is a good predictor of outcome in pediatric intensive care unit and is comparable with mortality scores.
Endocrinology
Lipid accumulation product is a predictor of nonalcoholic fatty liver disease in childhood obesity
Bahar Özcabı, Salih Demirhan, Mesut Akyol, Hatice Öztürkmen Akay, Ayla Güven
Clin Exp Pediatr. 2019;62(12):450-455.   Published online October 28, 2019
Background: Lipid accumulation product (LAP) is associated with the presence and severity of nonalcoholic fatty liver disease (NAFLD) in adults.
Purpose: Here we evaluated the ability of LAP to predict NAFLD in obese children. Methods: Eighty obese children (38 girls; age 6–18 years) were included. Anthropometric measurements and biochemical values were obtained from the patients’ medical records. LAP was calculated as [waist...
Neonatology (Perinatology)
Hypoxia-inducible factor: role in cell survival in superoxide dismutase overexpressing mice after neonatal hypoxia-ischemia
Ga Won Jeon, R. Ann Sheldon, Donna M Ferriero
Clin Exp Pediatr. 2019;62(12):444-449.   Published online October 18, 2019
Background: Sixty percent of infants with severe neonatal hypoxic-ischemic encephalopathy die, while most survivors have permanent disabilities. Treatment for neonatal hypoxic-ischemic encephalopathy is limited to therapeutic hypothermia, but it does not offer complete protection. Here, we investigated whether hypoxia-inducible factor (HIF) promotes cell survival and suggested neuroprotective strategies.
Purpose: HIF-1α-deficient mice have increased brain injury after neonatal hypoxia-ischemia (HI), and the...
Nephrology (Genitourinary)
Clinical manifestations of BK virus infection in pediatric kidney transplant patients
Yiyoung Kwon, Jeong Yeon Kim, Yeonhee Lee, Heeyeon Cho
Clin Exp Pediatr. 2019;62(11):422-427.   Published online September 5, 2019
Background: Polyomavirus BK (BKV) infection is an important cause of graft loss in kidney transplant patients.
Purpose: The purpose of this study was to evaluate clinical findings and risk factors for BKV in pediatric patients after kidney transplantation. Methods: This retrospective single-center study included 31 pediatric kidney transplant recipients from January 2002 to December 2017. Two patients received 2 transplantations during the...
Gastroenterology
Association between Body Mass Index and Hepatitis B antibody seropositivity in children
Yoowon Kwon, Su Jin Jeong
Clin Exp Pediatr. 2019;62(11):416-421.   Published online August 12, 2019
Background: The seropositivity rate of hepatitis B surface antigen (anti-HBs) antibodies is known to be ≥95% after hepatitis B virus vaccination during infancy. However, a low level or absence of anti-HBs in healthy children is discovered in many cases. Recent studies in adults reported that a reduced anti-HBs production rate is related to obesity.
Purpose: To investigate whether body mass index...
Influence of proton pump inhibitor therapy on intestinal inflammation assessed by fecal calprotectin in pediatric patients
Su Yeong Kim, Na Mi Lee, Sin Weon Yun, Soo Ahn Chae, In Seok Lim, Eung Sang Choi, Dae Yong Yi
Clin Exp Pediatr. 2019;62(10):400-404.   Published online July 3, 2019
Background: An increase in the numbers of patients with gastrointestinal symptoms has recently been observed.
Purpose: To investigate the effects of proton pump inhibitor (PPI) therapy on intestinal inflammation in children and adolescents as confirmed by clinical manifestations and objectively assessed by fecal calprotectin (FC) level measurement. Methods: Consecutive children (aged 3–18 years) who presented with gastrointestinal symptoms and were treated with...
Endoscopic postdilatation application of Mitomycin C in children with resistant esophageal strictures
Yasser K. Rashed, Mohamed El-Guindi
Clin Exp Pediatr. 2019;62(10):395-399.   Published online June 24, 2019
Background: The esophagus is the most common part of gastrointestinal (GI) tract at the risk of stricture. Benign disorders are the leading causes of narrowing. Caustic ingestion is the most common cause of esophageal stricture in children, especially in developing countries. Clinical responses to the topical application of Mitomycin C in various medical procedures have been reported.
Purpose: The study aimed...
Neonatology (Perinatology)
Clinical impact of admission hypothermia in very low birth weight infants: results from Korean Neonatal Network
Na Hyun Lee, Soo Kyung Nam, Juyoung Lee, Yong Hoon Jun
Clin Exp Pediatr. 2019;62(10):386-394.   Published online May 22, 2019
Background: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5°C–37.5°C.
Purpose: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. Methods: A cohort study using prospectively collected data involving...
Developmental and Behavioral Medicine
Effect of omega-3 plus methylphenidate as an alternative therapy to reduce attention deficit-hyperactivity disorder in children
Soleiman Mohammadzadeh, Narmin Baghi, Fayegh Yousefi, Bahar Yousefzamani
Clin Exp Pediatr. 2019;62(9):360-366.   Published online May 20, 2019
Background: Attention deficit-hyperactivity disorder (ADHD) is one of the most common chronic behavioral disorders in school-aged children.
Purpose: This study aimed to evaluate the effect of omega-3 supplementation as an alternative therapy for ADHD, which can be caused by vitamin and mineral deficiencies. Methods: This was a double-blinded clinical trial study. Sixty-six children with ADHD (aged 6–12 years) referred to our child...
Allergy
Nasal eosinophilia and eosinophil peroxidase in children and adolescents with rhinitis
Yeonu Choi, Haeun Jeon, Eun Ae Yang, Jong-Seo Yoon, Hyun Hee Kim
Clin Exp Pediatr. 2019;62(9):353-359.   Published online April 24, 2019
Background: Researchers have shown that eosinophil peroxidase (EPO) is a relatively accurate marker of eosinophilia and eosinophil activity. However, its use as a marker of eosinophilic inflammation in nasal secretions is limited because the diagnostic cutoff values of EPO for use as a one-time test for allergic diseases such as allergic rhinitis have not been established.
Purpose: To identify the correlation...
Nutrition
The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
Nehal Mohamed El Koofy, Hanaa Ibrahim Rady, Shrouk Moataz Abdallah, Hafez Mahmoud Bazaraa, Walaa Ahmed Rabie, Ahmed Ali El-Ayadi
Clin Exp Pediatr. 2019;62(9):344-352.   Published online April 2, 2019
Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to...
General Pediatrics
Prevalence of hyperuricemia and its association with metabolic syndrome and cardiometabolic risk factors in Korean children and adolescents: analysis based on the 2016–2017 Korea National Health and Nutrition Examination Survey
Jung Hyun Lee
Clin Exp Pediatr. 2019;62(8):317-323.   Published online June 24, 2019

Purpose: Investigating the prevalence of hyperuricemia and its association with metabolic syndrome (MetS) and cardiometabolic risk factors (CMRFs) in Korean children and adolescents. Methods: This cross-sectional survey used data from the 7th Korea National Health and Nutrition Examination Survey (2016–2017); 1,256 males and females aged 10–18 years were included. Hyperuricemia was defined as serum uric acid levels were >6.6 mg/dL at...
Neurology
Evaluation of hematologic profile may be needed for patients treated with oxcarbazepine
Gu Hyun Jung, Su Jeong You
Clin Exp Pediatr. 2019;62(8):312-316.   Published online April 11, 2019

Purpose: The major side effects of treatment with oxcarbazepine (OXC) are skin rash and hyponatremia. Hematologic side effects are reported rarely. The aim of this study was to investigate the rate and types of the hematologic side effects of OXC. Methods: The medical records of 184 patients diagnosed with epilepsy or movement disorder and on OXC monotherapy, at the Department of...
Neonatology (Perinatology)
The relation between serum levels of epidermal growth factor and necrotizing enterocolitis in preterm neonates
Heba Mostafa Ahmed, Nsreen Mostafa Kamel
Clin Exp Pediatr. 2019;62(8):307-311.   Published online March 15, 2019

Purpose: Necrotizing enterocolitis (NEC) is one of the most serious complications of prematurity. Many risk factors can contribute to the development of NEC. The epidermal growth factor (EGF) plays a major role in intestinal barrier function, increases intestinal enzyme activity, and improves nutrient transport. The aim of this study was to assess the role of epidermal growth factor in the...
Cardiology
Iron deficiency anemia as a predictor of coronary artery abnormalities in Kawasaki disease
Sohyun Kim, Lucy Youngmin Eun
Clin Exp Pediatr. 2019;62(8):301-306.   Published online February 8, 2019

Purpose: Coronary artery abnormalities (CAA) are the most important complications of Kawasaki disease (KD). Iron deficiency anemia (IDA) is a prevalent micronutrient deficiency and its association with KD remains unknown. We hypothesized that presence of IDA could be a predictor of CAA. Methods: This retrospective study included 173 KD patients, divided into 2 groups according to absence (group 1) and presence...
Neurology
Correlation of serum S100B levels with brain magnetic resonance imaging abnormalities in children with status epilepticus
Prastiya Indra Gunawan, Darto Saharso, Dian Purnama Sari
Clin Exp Pediatr. 2019;62(7):281-285.   Published online May 8, 2019

Purpose: To evaluate the association between elevated S100B levels with brain tissue damage seen in abnormalities of head magnetic resonance imaging (MRI; diffusion tensor imaging [DTI] sequence) in patients with status epilepticus (SE). Methods: An analytical observational study was conducted in children hospitalized at Dr Soetomo Hospital, Surabaya, from July to December 2016. The patients were divided into 2 groups: SE...
Endocrinology
Comparison of effectiveness of growth hormone therapy according to disease-causing genes in children with Noonan syndrome
Kyo Jin Jo, Yoo Mi Kim, Ju Young Yoon, Yeoun Joo Lee, Young Mi Han, Han-Wook Yoo, Hyang-Sook Kim, Chong Kun Cheon
Clin Exp Pediatr. 2019;62(7):274-280.   Published online December 3, 2018

Purpose: To analyze the growth response to growth hormone (GH) therapy in prepubertal patients with Noonan syndrome (NS) harboring different genetic mutations. Methods: Twenty-three patients with prepubertal NS treated at Pusan National University Children’s Hospital between March 2009 and July 2017 were enrolled. According to the disease-causing genes identified, the patients with NS were divided into 4 groups. Three groups were...
Neurology
Efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy
Yuni Yun, Dongsub Kim, Yun-Jeong Lee, Soonhak Kwon, Su-Kyeong Hwang
Clin Exp Pediatr. 2019;62(7):269-273.   Published online December 26, 2018

Purpose: There is limited data on the use of perampanel in children under 12 years of age. We evaluated the efficacy and tolerability of adjunctive perampanel treatment in children under 12 years of age with refractory epilepsy. Methods: This retrospective observational study was performed in Kyungpook National University Hospital from July 2016 to March 2018. A responder was defined as a...
Endocrinology
Secular change in waist circumference and waist-height ratio and optimal cutoff of waist-height ratio for abdominal obesity among Korean children and adolescents over 10 years
Min Sub Kim, Se Young Kim, Jae Hyun Kim
Clin Exp Pediatr. 2019;62(7):261-268.   Published online December 3, 2018

Purpose: This study aimed to evaluate the time trends of waist circumference (WC) and waist-height ratio (WHR), and to present WC and WHR distributions with optimal WHR cutoff for abdominal obesity in Korean children and adolescents. Methods: We performed a retrospective cross-sectional analysis of data from 13,257 children and adolescents (6,987 boys and 6,270 girls) aged 6–18 years who were included...
Cardiology
Change of coronary artery indices according to coronary dominance pattern in early childhood
Yoon jin Lee, Kyoung Soo Park, Hong Ryang Kil
Clin Exp Pediatr. 2019;62(6):240-243.   Published online November 22, 2018

Purpose: Coronary arterial lesion assessment in children can be difficult, depending on the coronary dominance pattern. Although it is easier to determine coronary dominance with echocardiography in children than in adults, it is still difficult. This study aimed to examine the coronary dominance pattern according to the objective coronary artery (CA) indices. Methods: The CA diameter, aortic valve annulus, and abdominal...
High antistreptolysin O titer is associated with coronary artery lesions in patients with Kawasaki disease
Dong Eun Min, Do Hee Kim, Mi Young Han, Sung Ho Cha, Kyung Lim Yoon
Clin Exp Pediatr. 2019;62(6):235-239.   Published online November 7, 2018

Purpose: In Kawasaki disease (KD) patients, coronary artery complications, incomplete and refractory types occur more frequently in patients with streptococcal or other bacterial/viral infections. Recently, we observed a higher incidence of coronary lesions in KD patients with high anti-streptolysin O (ASO) titer. Therefore, we hypothesized that KD patients diagnosed with concurrent streptococcal infection have poor prognosis, with respect to treatment...
Genetics and Metabolism
Clinical and molecular characterization of Korean children with infantile and late-onset Pompe disease: 10 years of experience with enzyme replacement therapy at a single center
Min-Sun Kim, Ari Song, Minji Im, June Huh, I-Seok Kang, Jinyoung Song, Aram Yang, Jinsup Kim, Eun-Kyung Kwon, Eu-Jin Choi, Sun-Ju Han, Hyung-Doo Park, Sung Yoon Cho, Dong-Kyu Jin
Clin Exp Pediatr. 2019;62(6):224-234.   Published online October 4, 2018

Purpose: Pompe disease (PD) is an autosomal recessive disorder caused by a deficiency of acid alphaglucosidase resulting from pathogenic GAA variants. This study describes the clinical features, genotypes, changes before and after enzyme replacement therapy (ERT), and long-term outcomes in patients with infantile-onset PD (IOPD) and late-onset PD (LOPD) at a tertiary medical center. Methods: The medical records of 5 Korean...
Neonatology (Perinatology)
Diagnostic value of eosinopenia and neutrophil to lymphocyte ratio on early onset neonatal sepsis
Rocky Wilar
Clin Exp Pediatr. 2019;62(6):217-223.   Published online October 8, 2018

Purpose: To determine the diagnostic value of eosinopenia and the neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of early onset neonatal sepsis (EONS). Methods: This cross-sectional study was conducted in the Neonatology Ward of R.D. Kandou General Hospital Manado between July and October 2017. Samples were obtained from all neonates meeting the inclusion criteria for EONS. Data were encoded using logistic regression...
Developmental and Behavioral Medicine
Validity of the Korean Developmental Screening Test for very-low-birth-weight infants
Chae Young Kim, Euiseok Jung, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
Clin Exp Pediatr. 2019;62(5):187-192.   Published online March 20, 2019

Purpose: The importance of the neurodevelopmental outcomes of very-low-birth-weight (VLBW) infants has been emphasized as their mortality rate has markedly improved. This study aimed to assess the validity of the Korean Developmental Screening Test (K-DST), a developmental screening tool approved by the Korean Society of Pediatrics, for the timely diagnosis of neurodevelopmental delay in VLBW infants. Methods: Subjects included VLBW infants...
Endocrinology
Prevalence and associates of obesity and overweight among school-age children in a rural community of Thailand
Teechaya Nonboonyawat, Wuttipat Pusanasuwannasri, Nattanon Chanrat, Natta Wongthanavimok, Danutanut Tubngern, Piengkwan Panutrakul, Mathirut Mungthin, Thirapa Nivesvivat, Panadda Hatthachote, Ram Rangsin, Phunlerd Piyaraj
Clin Exp Pediatr. 2019;62(5):179-186.   Published online February 8, 2019

Purpose: Information about overweight and obesity among students in rural areas of Thailand is limited. Therefore, we aimed to determine overweight and obesity prevalences and associated factors among school-aged children in a rural community of Thailand. Methods: We selected 9 public schools through cluster sampling in 2 provinces located in central Thailand in 2016. Anthropometric measurements were measured using standard techniques,...
Gastroenterology
The role of Lactobacillus reuteri DSM 17938 for the absorption of iron preparations in children with iron deficiency anemia
Jeanette Manoppo, Hilda Tasiringan, Audrey Wahani, Adrian Umboh, Max Mantik
Clin Exp Pediatr. 2019;62(5):173-178.   Published online January 25, 2019

Purpose: To determine whether Lactobacillus reuteri DSM 17938 plays a role in absorption of iron preparations given to children with iron deficiency anemia (IDA). Methods: We performed a quasi-experimental study involving pre- and postintervention tests using a control group in North Sulawesi province, Indonesia, between July and September 2017. We conducted a single-blind controlled trial that included primary school children who...
Neonatology (Perinatology)
Association between vitamin D level at birth and respiratory morbidities in very-low-birth-weight infants
Ian Kim, Sung Shin Kim, Jee In Song, Seock Hwa Yoon, Ga Young Park, Yong-Wha Lee
Clin Exp Pediatr. 2019;62(5):166-172.   Published online October 24, 2018

Purpose: This study aimed to evaluate vitamin D status at birth in very-low-birth-weight infants (VLBWIs: <1,500 g) and to determine the association between vitamin D level and respiratory morbidity. Methods: A retrospective study was conducted at Soonchunhyang University Bucheon Hospital between November 2013 and November 2017. We collected blood samples and data on respiratory morbidity from 230 VLBWIs on the first...
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