"Most viewed" Articles are from the articles published in 2022 during the last six month.
Question: What is the overall effect of obesity interventions among Korean children and what affects their effectiveness? Finding: Interventions were strongly favored over controls. Interventions including at least one physical activity component were significantly better than those that did not. Sex, age, baseline weight category, intervention duration, and the number of intervention components were not significant. Meaning: Future obesity interventions for Korean children must seek to include physical activity components. |
∙ Rotavirus infection-associated central nervous system (CNS) complications are fairly common in children. ∙ Common clinicoradiological features include benign convulsions with mild gastroenteritis, acute encephalopathies/encephalitis, cerebellitis, and neonatal rotavirus-associated leukoencephalopathy. ∙ Possible mechanisms for CNS complications include direct viral invasion into the brain via several potential routes such as the blood-brain barrier and vagus nerve, and entry of various brain-damaging mediators and activated immune cells into the brain. |
· Big data analysis, such as common data model and artificial intelligence, can solve relevant questions and improve clinical care. · Recent deep learning studies achieved 0.887–0.996 areas under the receiver operating characteristic curve for automated interictal epileptiform discharge detection. · Recent deep learning studies achieved 62.3%–99.0% accuracy for interictal-ictal classification in seizure detection and 75.0%– 87.8% sensitivity with a 0.06–0.21/hr false positive rate in seizure forecasting. |
· The innovation of healthcare information communication technology (ICT) was accelerated with the adoption of electronic health records (EHRs). · Telemedicine currently has no technical barriers. · EHRs and personal health records are being connected, and mobile/wearable technologies are being integrated into them. · Conventional rule-based clinical decision support systems have already been implemented and used in EHRs and PHRs. Artificial intelligence/machine learning improves precision and accuracy. |
SpO2/FiO2 ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients. |
∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial. ∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage. ∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life. ∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism. |
∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes. ∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%. ∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants. ∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life. ∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring. |
· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition. · SIBO is prevalent in children and adolescents with functional abdominal pain disorders. · Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria. · Breath tests are safe and noninvasive. · Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics. |
· Congenital cytomegalovirus (CMV) infection is among the most common causes of nongenetic sensorineural hearing loss. · Congenital CMV is initially treated with intravenous ganciclovir for 2–6 weeks and switched to oral valganciclovir, or with oral valganciclovir for the entire 6-month period. · Infants with congenital CMV require periodic monitoring of absolute neutrophil count, platelet count, and blood urea nitrogen, creatinine, liver function tests, audiological, ophthalmological, and developmental tests during antiviral medication. |
· Dendritic, regulatory T, and regulatory B cells significantly contribute to the natural course of food allergy. · Cow’s milk and hen’s egg allergies tend to resolve in earlier childhood but recent studies show that 50% of patients still persist into school age. · The potential factors affecting the natural course of food allergy are age at diagnosis, symptom severity, sensitization status and its change rate, and external factors such as diet and interventions. · There is a considerable possibility of food allergy outgrow if specific IgE levels are 2–5 kUA/L or less, but other factors such as age and recent symptoms should be considered together. · With a clear understanding of the natural course of food allergy, pediatricians can provide appropriate assessment and interventions to our patients, and consequently can help patients overcome their food allergy and improve the social safety net. |
Background: According to the National Family Health Survey– 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.
Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among... |
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking. |
· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates. · Etiologies vary, and up to 80% of cases are genetic. · Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention. |
∙ 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. |
Question: How can the management of neonatal jaundice (NJ) be enhanced through telemedicine? Finding: Teleconsultations, drive-through testing, and the use of an application to assess neonatal jaundice at home are being successfully used, but they must be further researched before being implemented on a larger scale. Meaning: Recent technology allows for the treatment of NJ at home with an application that helps reduce hospital burden. |
Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)? Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects. Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique. |
Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants? Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants. Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants. |
· 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. |
Since the introduction of a universal Japanese encephalitis (JE) vaccination program and urbanization, the incidence of JE has dramatically decreased in Korea. However, recent JE cases have occurred, predominantly among unvaccinated adults and with a shift in age distribution. Continuous surveillance of the seroprevalence of JE is required to establish a proper immunization policy in Korea. |
· Childhood chronic kidney disease (CKD) is complex and requires lifetime medical treatment. · Children with CKD are at risk for emotional, behavioral, social, and academic difficulties that significantly affect their quality of life. · Caring for children with CKD is stressful for families. · These unique challenges are crucial and can negatively impact treatment outcomes. · Awareness of and addressing these evolving psychosocial issues can foster their developing needs. |
· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea. · Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD. · Insulin resistance is closely related to NAFLD. |
∙ 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. |
Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants? Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding. Meaning: Plastic bottles feeding alters bodily functions in infants. |
Several observational studies have shown that acute kidney injury affects up to 46% of children and adolescents who develop severe postinflammatory responses, such as multisystem inflammatory syndrome in childhood, due to coronavirus disease 2019 (COVID-19). Although causality has not been established, some cases of glomerulopathy or nephrotic syndrome occurring after COVID-19 infection or vaccination have been reported. Therefore, kidney complications associated with these conditions in children and adolescents warrant attention. |
Question: What effects do maternal and child factors have on stunting? Are there significant indicators of stunting? Finding: Child and maternal factors had 49.8% and 30.3% effects on stunting, respectively. The primary child factor was infant formula dose, while the primary maternal factor was nutritional status. Meaning: More attention to nutritional status during pregnancy and ensuring the appropriate dose of infant formula at ages 6–24 months can prevent stunting. |
· Intussusception, the most common cause of small bowel obstruction in young children, has an overall incidence in Korea of 28.3 cases per 100,000 person-years. · Its cause is idiopathic inmost cases, although viral or bacterial gastroenteritis has beenpostulated as a cause. Approximately 4% of children have pathological lead points for intussusception, and Meckel’s diverticulum is the most common cause. · Intussusception in preterm infants is extremely rare. Older children (>5 years of age) are at increased risk of pathological lead points. |
Question: Have polycystic ovary syndrome (PCOS) increased risk of having an offspring with attention-deficit/hyperactivity disorder (ADHD)? Finding: Six articles (3 cohort and 3 case-control studies; 401,413 total ADHD cases) met the study criteria. Maternal PCOS was associated with an increased risk of ADHD in the offspring based on odds ratio (OR) and relative ratio (RR) (OR, 1.42; 95% confidence interval [CI], 1.27–1.57) and (RR, 1.43; 95% CI, 1.35–1.51), respectively. Meaning: Our study showed that maternal PCOS is a risk factor for ADHD. |
· Pediatric cerebrospinal fluid (CSF) components have been extensively evaluated as biomarkers of various neurologic diseases. · Several promising candidate CSF biomarkers, including Tau, glial fibrillary acidic protein, neuron-specific enolase, S100β, and interleukins, have been studied in pediatric patients with seizure disorders, central nervous system infections, inflammation, tumors, hypoxic-ischemic encephalopathy, traumatic brain injuries, intraventricular hemorrhage, and congenital hydrocephalus. · Circulating microRNAs in the CSF are a promising class of biomarkers for various neurological diseases. |
∙ The novel coronavirus disease 2019 (COVID-19) was first reported in December 2019 as a cluster outbreak in Wuhan, since then, national lockdowns have included school closures, stay-at-home orders. ∙ The characteristics of adolescent fractures were often related to physical activity such as sports-related injury. ∙ During the COVID-19 pandemic, both in the East and the West, the incidence of fractures in children and adolescents is showing a decreasing trend worldwide. ∙ Fractures in children and adolescents were significantly reduced in the proportion of relatively low-energy damage, and the incidence of fractures in adolescents with greater activity compared to children was reduced. ∙ If COVID-19 pandemic ends, normal academic and sports activities increase due to the easing of lockdown policies, the number of trauma patients related to increased activity may increase rapidly, and clinics should prepare for this change. |
∙ The coronavirus disease 2019 (COVID-19) pandemic has required preventive measures like self-quarantine, school closures, and lockdown, which ultimately make youth directly and indirectly vulnerable to depression, anxiety, posttraumatic stress disorder, and somatization. ∙ Child abuse is more common in the COVID-19 era than previously. ∙ Pediatricians should carefully examine parental and child mental health to directly and indirectly aid their physical and mental health. |