Clinical and Experimental Pediatrics

Editorial

Gastroenterology

Gut microbiota’s impact on obesity (24 times)

Sujin Jeong

Clin Exp Pediatr. 2023;66(7):294-295. Published online June 14, 2023

· An imbalance of the gut microbiota with a relative increase in Firmicutes versus Bacteroidetes is associated with the pathogenesis of obesity.
· Dysbiosis is associated with microbial genes associated with short-chain fatty acids (SCFA) production and increased colonic SCFA levels. SCFAs have also been shown to regulate appetite and satiety hormones, which can affect food intake and energy balance.
· A dietary high-fat intake is reportedly associated with increased plasma lipopolysaccharide. Altered Toll-like receptor-4 signaling leads to propagating the cascade of further inflammation and promoting insulin resistance.

DOI: https://doi.org/10.3345/cep.2023.00458

Review Article

Nutrition

Total energy expenditure measured by doubly labeled water method in children and adolescents: a systematic review (23 times)

Nahyun Kim, Jonghoon Park

Clin Exp Pediatr. 2023;66(2):54-65. Published online October 17, 2022

This systematic review summarizes convincing evidence that total energy expenditure (TEE) measured using the doubly labeled water technique increased with age from 1 to 18 years, while fat-free mass (FFM) increased with growth. TEE and in normal-weight participants, while physical activity level did not differ from that of normal-weight participants.

DOI: https://doi.org/10.3345/cep.2022.00472

Original Article

Gastroenterology

Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome (23 times)

Ozlem Kara, Hanife Aysegul Arsoy, Murat Keskin

Clin Exp Pediatr. 2023;66(9):395-402. Published online June 14, 2023

Web of Science 2 Crossref 1

Question: Is polycystic ovary syndrome (PCOS) a risk factor for nonalcoholic fatty liver disease (NAFLD) in adolescents?
Finding: The frequency of NAFLD did not increase in adolescents with PCOS. However, hyperandrogenemia was a risk factor for NAFLD.
Meaning: Adolescents with PCOS and hyperandrogenemia should be closely monitored for hepatic steatosis.

DOI: https://doi.org/10.3345/cep.2023.00353

Review Article

Gastroenterology

Clinical importance of immunonutrition in infants: a review of the recent literature (22 times)

Ji Sook Park

Clin Exp Pediatr. 2022;65(7):337-343. Published online February 17, 2022

Web of Science 2 Crossref 2

Nutrients are important in the developing immune system. Human milk supplies diverse bioactives to prevent acute infection or chronic inflammation. Immunoglobulins, lactoferrin, and glutamine in human milk decrease gastrointestinal and respiratory infection. Human milk oligosaccharides promote the growth of intestinal microbiota, the gut barrier, and antimicrobial or antiviral activity. Micronutrients act as anti-inflammatory immunonutrients, too. However, the toxicity of some nutrients from an overdose should be considered.

DOI: https://doi.org/10.3345/cep.2021.00570

Editorial

Nephrology (Genitourinary)

Optimal hemodialysis treatment for pediatric kidney failure patients (22 times)

Yo Han Ahn

Clin Exp Pediatr. 2023;66(3):125-126. Published online February 15, 2023

· Although the basic concept of hemodialysis (HD) is similar in adults and children, specific factors must be considered in the latter, including the small dialyzer and circuit, difficult vascular access, and frequent complications.
· HD-associated complications include catheter-related problems, hemodynamic instability, and neurodevelopmental and cognitive dysfunction.
· Pediatric HD is challenging, and steady efforts are needed to perform it safely and reduce its complications, thereby improving clinical outcomes.

DOI: https://doi.org/10.3345/cep.2022.01431

Letter to the Editor

Pulmonology

Metabolic syndrome and pulmonary dysfunction in asthmatic children during the COVID-19 pandemic (22 times)

Jue Seong Lee, Sang Hyun Park, Yoon Lee, Seunghyun Kim, Wonsuck Yoon, Young Yoo

Clin Exp Pediatr. 2024;67(3):168-170. Published online February 19, 2024

DOI: https://doi.org/10.3345/cep.2023.01480

Neonatology (Perinatology)

Assessment of iron status and red cell parameters in healthy term small for gestational age neonates at birth (22 times)

Arif Hossain, Shorna Rahman, Shahana Akter, Ismat Jahan, Sanjoy Kumer Dey, Abdul Mannan, Mohammod Shahidullah

Clin Exp Pediatr. 2024;67(4):221-223. Published online March 19, 2024

DOI: https://doi.org/10.3345/cep.2023.01445

Original Article

Cardiology

Vasovagal syncope with mild versus moderate autonomic dysfunction: a 13-year single-center experience (21 times)

Han Eoul Lee, Dong Won Lee

Clin Exp Pediatr. 2022;65(1):47-52. Published online June 1, 2021

Web of Science 1 Crossref 1

Question: It is well known that autonomic dysfunction contributes to vasovagal syncope (VVS). Does the degree of autonomic dysfunction contribute to clinical manifestations, diagnostic methods, treatment, and prognosis?
Finding: The clinical manifestations, diagnostic methods, treatment, and prognosis differ between patients with mild and moderate degrees of autonomic dysfunction.
Meaning: VVS is caused by autonomic dysfunction, but autonomic dysfunction severity need not be classified.

DOI: https://doi.org/10.3345/cep.2021.00052

Review Article

Oncology

Application of 3-dimensional printing implants for bone tumors (21 times)

Jong Woong Park, Hyun Guy Kang

Clin Exp Pediatr. 2022;65(10):476-482. Published online December 23, 2021

Web of Science 8 Crossref 11

∙ The application of 3-dimensional (3D) printing in orthopedic oncology is summarized into bone and tumor modeling, patient-specific instruments (PSIs), custom-made implants, and tissue engineering.
∙ The 3D-printed customized implant is the most central application, while modeling and PSI often play adjunct roles.
∙ Short-term surgical outcomes of custom-made 3D-printed implants are promising.

DOI: https://doi.org/10.3345/cep.2021.01326

Editorial

Allergy

Dietary restriction misconceptions and food allergy education in children with atopic dermatitis (21 times)

You Hoon Jeon

Clin Exp Pediatr. 2022;65(2):83-84. Published online January 27, 2022

Web of Science 5 Crossref 4

∙ Food intake strategies for preventing food allergies have undergone major changes over the past 20 years.
∙ In children with atopic dermatitis, indiscriminate food restrictions without diagnostic testing leads to nutritional imbalance and poor growth.
∙ When determining food restrictions for pediatric patients with atopic dermatitis, an accurate food allergy diagnosis must be preceded, and continuous parental education about food intake is required.

DOI: https://doi.org/10.3345/cep.2021.01634

Review Article

Neonatology (Perinatology)

Neonatal seizures: stepping outside the comfort zone (21 times)

Menna Hashish, Mohamed Reda Bassiouny

Clin Exp Pediatr. 2022;65(11):521-528. Published online April 4, 2022

Web of Science 2 Crossref 2

· Use conventional and amplitude-integrated electroencephalography to confirm clinical seizures and screen high-risk newborns.
· Select an explicit clear elective event to be treated with less toxic and more effective antiepileptics.

DOI: https://doi.org/10.3345/cep.2022.00115

Cardiology

Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections (21 times)

Young Hwan Lee

Clin Exp Pediatr. 2023;66(1):1-11. Published online June 22, 2022

Web of Science 2 Crossref 2

· The etiology of Kawasaki disease (KD) is unclear, but its clinical, epidemiological, and pathophysiological characteristics are strongly associated with infectious diseases.
· In the coronavirus disease 2019 pandemic era, viruses are attracting the most attention. Sudden acute respiratory syndrome coronavirus 2 infection causes various hyperinflammation in children that require differentiation from KD.
· Immune responses in patients with KD may be induced by host cell damage. To effectively prevent and treat KD, the genetic background and immune responses of KD patients and triggering pathogens require identification.

DOI: https://doi.org/10.3345/cep.2022.00150

Original Article

Gastroenterology

Probiotics added to maternal nutrition affect ınfantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study (21 times)

Aysu Yıldız Karaahmet, Gülümser Dolgun, Metehan Özen

Clin Exp Pediatr. 2022;65(11):547-554. Published online September 23, 2022

Web of Science 2 Crossref 2

Question: Do probiotics added to maternal nutrition affect infantile colic symptoms and intestinal microbiota?
Finding: Infants whose mothers ingested probiotics demonstrated decreased crying frequency and intensity and significantly increased bacterial diversity in the stools. The bacterial variety was substantially affected by the added probiotic product.
Meaning: The addition of probiotics to maternal nutrition in early infancy could play an important role in preventing infantile colic.

DOI: https://doi.org/10.3345/cep.2022.00766

Review Article

Gastroenterology

High-resolution esophageal manometry in children (21 times)

Yogesh Waikar

Clin Exp Pediatr. 2023;66(4):155-160. Published online October 17, 2022

Web of Science 1 Crossref 1

High-resolution esophageal manometry can be safely performed in children where recurrent vomiting and persistent dysphagia is the working diagnosis after excluding nonluminal and structural obstructive pathologies using pediatric upper gastrointestinal endoscopy. Normal manometry values are available. Clinical picture, biochemical tests, radiological interpretation, and endoscopic findings with manometry completes the analysis of patients with recurrent vomiting and dysphagia.

DOI: https://doi.org/10.3345/cep.2022.00787

Nutrition

Protein substitutions as new-generation pharmanutrition approach to managing phenylketonuria (21 times)

Fatma Nur Keskin, Teslime Özge Şahin, Raffaele Capasso, Duygu Ağagündüz

Clin Exp Pediatr. 2023;66(8):320-331. Published online November 1, 2022

Phenylketonuria, an autosomal recessive disease that results from the inability to metabolize phenylalanine, is currently treated with medical nutrition therapy. New treatment approaches such as tetrahydrobiopterin, glycomacropeptide, large neutral amino acids, pegvaliase, and gene therapy significantly impact disease management and dietary enrichment. This article also reviews animal and human studies that have evaluated the efficacy and safety of these new protein substitutes.

DOI: https://doi.org/10.3345/cep.2022.00584

Original Article

Neurology

Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review (21 times)

Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga

Clin Exp Pediatr. 2023;66(1):38-45. Published online November 30, 2022

Web of Science 3 Crossref 2

· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.

DOI: https://doi.org/10.3345/cep.2022.01102

Review Article

Neurology

Worldwide national intervention of developmental screening programs in infant and early childhood (20 times)

Seunghyo Kim

Clin Exp Pediatr. 2022;65(1):10-20. Published online September 30, 2021

Web of Science 10 Crossref 10

∙ Prevalence rate of developmental disabilities has been reported from 8% to 15% and its rate is increasing worldwide.
∙ The critical period of intervention for developmental delay is before the child reaches 3 years of age.
∙ All primary care pediatricians should conduct developmental surveillance and screening tests to infants and children at scheduled visits. Through this, they are liable for providing early identification and timely intervention.

DOI: https://doi.org/10.3345/cep.2021.00248

Gastroenterology

Role of social media use in onset of functional gastrointestinal disorders in children (20 times)

Mauro Cinquetti, Vanessa Dargenio, Michele Fingerle, Carolina Marchiotto, Marco Biasin, Massimo Pettoello Mantovani, Flavia Indrio

Clin Exp Pediatr. 2023;66(6):226-232. Published online December 21, 2022

Web of Science 1 Crossref 1

· Social media use can cause adverse health outcomes, including gastrointestinal disorders, in children and adolescents.
· Recent findings have shown a high prevalence of social media use and decreased well-being in patients with functional gastrointestinal disorders.
· The biopsychosocial nature of functional gastrointestinal disorders and the clear influence of social media on the psychosocial lives of children suggests the likely involvement of social media in their development.

DOI: https://doi.org/10.3345/cep.2022.00843

General Pediatrics

Korean Developmental Screening Test for Infants and Children (K-DST): development, applications, and implications for future early childhood development interventions (20 times)

Dooyoung Kim, Young June Choe, Bilal Aurang Zeb Durrani, EunYoung Kim, Junghye Byeon, Baik-Lin Eun

Clin Exp Pediatr. 2023;66(7):288-293. Published online December 22, 2022

Web of Science 1 Crossref 2

· This review discusses the development and application of the Korean Developmental Screening Test for Infants and Children (K-DST) for ensuring early childhood development.
· Various studies have demonstrated the integral role of the K-DST in facilitating the detection of developmental delays and delivery of timely interventions.
· The tailoring of the K-DST to Korean infants and children suggests that other countries may further translate and adapt it.

DOI: https://doi.org/10.3345/cep.2022.00906

Gastroenterology

Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents (19 times)

Eun Sil Kim, Mi Jin Kim

Clin Exp Pediatr. 2022;65(1):21-28. Published online September 10, 2021

Web of Science 1 Crossref 2

· Clinical manifestations of upper gastrointestinal (UGI) tract involvement in Crohn's disease (CD) are common but often clinically underestimated.
· Diagnosing CD by confirming inflammation of the UGI tract histologically is challenging because macroscopic and microscopic findings overlap with those of other diseases.
· Ongoing efforts are needed to enable a standardized assessment of UGI CD in the future.

DOI: https://doi.org/10.3345/cep.2021.00661

Original Article

Neurology

Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the National Health Screening Program for Infants and Children database (19 times)

Og Hyang Kim, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, Yun Hye Jo, Seongyeong Rhie, Man Yong Han, Kyu Young Chae

Clin Exp Pediatr. 2022;65(6):312-319. Published online December 9, 2021

Web of Science 4 Crossref 4

Question: What comorbidities are increased in children with congenital muscular torticollis (CMT)? Are there differences in the neurodevelopmental outcomes of children with CMT who received physical therapy versus those who did not?
Finding: The risk of congenital musculoskeletal deformities is increased in CMT. Children who did not receive physical therapy were at greater risk of neurodevelopmental delay.
Meaning: In CMT, musculoskeletal comorbidities should be identified and active early treatment provided.

DOI: https://doi.org/10.3345/cep.2021.01417

Infection

Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study (19 times)

In Suk Sol, Eun Lee, Hyeon-Jong Yang, Yong Ju Lee, Hye Yung Yum, Mi-Hee Lee, Mi Ae Chu, Hui Jeong Moon, Hyo-Bin Kim, Ju Hee Seo, Jung Yeon Shim, Ji Young Ahn, Yoon Young Jang, Hai Lee Chung, Eun Hee Chung, Kyunghoon Kim, Bong-Seong Kim, Cheol Hong Kim, Yang Park, Meeyong Shin, Kyung Suk Lee, Man Yong Han, Soo-Jong Hong, Eun Kyeong Kang, Chang Keun Kim; on behalf of The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease

Clin Exp Pediatr. 2023;66(3):134-141. Published online December 22, 2022

Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown.
Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV.
Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic.

DOI: https://doi.org/10.3345/cep.2022.00703

Editorial

Infection

Impact and role of vitamins as immunonutrition in children during COVID-19 pandemic (19 times)

Yoo Min Lee

Clin Exp Pediatr. 2023;66(5):212-214. Published online April 18, 2023

· Vitamins have effector mechanisms in the innate and adaptive immune systems and potential roles in preventing and reducing the severity of coronavirus disease 2019 (COVID-19).
· Vitamins may be immunonutrients in the treatment of COVID-19 infections and prevention of patient deterioration due to critical illness, thus demonstrating the significance of a nutritious, well-balanced diet.

DOI: https://doi.org/10.3345/cep.2022.01305

Original Article

Developmental and Behavioral Medicine

Neonatal risk factors associated with attention-deficit/hyperactivity disorder: an umbrella review (19 times)

Ensiyeh Jenabi, Erfan Ayubi, Sajjad Farashi, Saeid Bashirian, Fereshteh Mehri

Clin Exp Pediatr. 2023;66(10):441-446. Published online July 14, 2023

Web of Science 1 Crossref 1

Question: The risk factors for attention deficit hyperactivity disorder (ADHD), such as breastfeeding, congenital heart disease, and low birth weight, in neonates are not well understood.
Finding: This umbrella review obtained significant effect sizes for ADHD for congenital heart disease (odds ratio [OR], 3.04), low birth weight (OR, 2.25), never breastfed (OR, 1.55), and Apgar score (OR, 1.30).
Meaning: Congenital heart disease, low birth weight, lack of breastfeeding, and Apgar scores were significant factors for ADHD.

DOI: https://doi.org/10.3345/cep.2022.01396

Editorial

Endocrinology

Pediatric obesity: life cycle approach of pediatrician and society (18 times)

Yong Hee Hong

Clin Exp Pediatr. 2022;65(1):29-30. Published online December 28, 2021

Web of Science 2 Crossref 3

• With the emerging epidemic of pediatric obesity, many endocrine comorbidities classically seen in adulthood are surfacing much earlier in life.
• Appropriate obesity counseling and education should be provided from infancy to adolescence.
• Managing pediatric obesity may require school and society involvement.

DOI: https://doi.org/10.3345/cep.2021.01536

Review Article

Infection

COVID-19 in immunocompromised children and adolescents (18 times)

Byung Ok Kwak, Byung Wook Eun

Clin Exp Pediatr. 2023;66(5):182-189. Published online April 18, 2023

Web of Science 5 Crossref 5

Most immunocompromised children and adolescents are not at increased risk of developing severe coronavirus disease 2019 (COVID-19). COVID-19 outcomes for low- or medium-risk immunocompromised children are favorable, while more serious illness reportedly occurs in high-risk immunocompromised children by underlying disease, its treatments, and other factors. Therefore, the early detection and timely management of severe COVID-19 and treatment of underlying disease are important. Hospitalization and COVID-19 vaccination should be carefully considered.

DOI: https://doi.org/10.3345/cep.2022.00878

Original Article

Pulmonology

Modified high-flow nasal cannula for children with respiratory distress (17 times)

Sarocha Itdhiamornkulchai, Aroonwan Preutthipan, Jarin Vaewpanich, Nattachai Anantasit

Clin Exp Pediatr. 2022;65(3):136-141. Published online May 24, 2021

Question: Can the modified high-flow nasal cannula (HFNC) provide alternative respiratory support for children with acute respiratory distress?
Finding: A total of 74 patients were assigned to the modified or commercial HFNC groups. The intubation rate, length of hospital stay, and adverse events did not differ between the 2 groups.
Meaning: The modified HFNC can provide alternative respiratory support for pediatric respiratory distress.

DOI: https://doi.org/10.3345/cep.2020.01403

Review Article

Endocrinology

Pediatric hypertension based on Japanese Society of Hypertension Guidelines (JSH 2019) with actual school blood pressure screening data in Japan (17 times)

Toru Kikuchi

Clin Exp Pediatr. 2022;65(6):283-290. Published online November 26, 2021

Web of Science 3 Crossref 4

The prevalence of Japanese pediatric hypertension is 0.9% based on proper measurement protocols. Hypertensive children tend to be hypertensive adults. Pediatric essential hypertension is characterized by an absence of symptoms, obesity, a family history of hypertension, and a low birth weight. The most common causes of pediatric secondary hypertension are renal parenchymal and renovascular diseases. Important factors controlling pediatric hypertension include healthy lifestyle modifications and pharmacotherapy.

DOI: https://doi.org/10.3345/cep.2021.00920

Original Article

Neonatology (Perinatology)

A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants (17 times)

Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun

Clin Exp Pediatr. 2023;66(1):32-37. Published online December 15, 2022

Web of Science 1 Crossref 1

Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.

DOI: https://doi.org/10.3345/cep.2022.00780

Editorial

Infection

COVID-19 infection and vaccination among children (17 times)

Amnuay Kleebayoon, Viroj Wiwanitkit

Clin Exp Pediatr. 2023;66(12):531-532. Published online August 30, 2023

· Coronavirus disease 2019 (OVID-19) infection and immunization have been linked with kidney problems; however, causality has not been proven.
· Concern about confounders is usually needed.
· Correspondence about a published article on the COVID-19 vaccine

DOI: https://doi.org/10.3345/cep.2023.00899

Cited By 23	Retinopathy of prematurity: a review of epidemiology and current treatment strategies
Cited By 20	Genetic factors in precocious puberty
Cited By 18	Global relationship between parent and child obesity: a systematic review and meta-analysis
Cited By 14	Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review
Cited By 13	Etiological and pathophysiological enigmas of severe coronavirus disease 2019, multisystem inflammatory syndrome in children, and Kawasaki disease

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