Article 69(11); Nov 2026
Review Article
Infection
Antibiotic pretreatment and culture yield in pediatric osteoarticular infection: a systematic review and meta-analysis
Mohamad Shieb, Caroline Decesare, Guyu Li, Elizabeth Ristagno
Clin Exp Pediatr. 2026;69(11):825-832.   Published online September 14, 2026
In this systematic review and meta-analysis of 9 studies comprising 1,704 tissue culture specimens from children with osteoarticular infection, antibiotic pretreatment was not associated with reduced tissue culture yield (odds ratio, 1.60; 95% confidence interval, 1.23–2.08). Empiric antibiotic therapy should not be withheld to preserve culture yield in suspected osteoarticular infection; invasive cultures should be obtained at the earliest safe opportunity without delaying treatment.
Pulmonology
Health literacy and emergency preparedness in pediatric tracheostomy and home ventilation: a practical review
Megan Pilcher, Weerapong Lilitwat
Clin Exp Pediatr. 2026;69(11):833-843.   Published online September 7, 2026
For children with tracheostomy and home ventilation, health literacy is a safety capacity, not merely reading ability. Existing guidelines define what a safe discharge system should contain; clinicians must also verify what caregivers can understand, demonstrate, and retain. An author-derived six-domain framework, staged multimodal teaching, teach-back, show-back, simulation, and longitudinal reassessment can translate recommendations into emergency action, while long-term outcome evidence remains limited.
Neonatology (Perinatology)
Association between surgical repair timing and mortality in neonates with congenital diaphragmatic hernia: a systematic review and meta-analysis
Veerabhadra Radhakrishna, Bharathi Balachander, Sanjana Hansoge Somanath, Hejmady Aneesh Shenoy, Srinivas Balachander
Clin Exp Pediatr. 2026;69(11):844-854.   Published online September 17, 2026
Preoperative stabilization is critical for the management of congenital diaphragmatic hernias. Surgical repair within 24 hours of life significantly increases mortality risk. A 24- to 48-hour stabilization window optimizes survival and resource utilization. Delaying surgery beyond 48 hours offers no additional survival benefits and increases morbidity. In neonates requiring extracorporeal membrane oxygenation, the exact surgical timing does not independently predict mortality.
Editorial
Infection
A commentary on “Effect of varicella vaccine introduction on chickenpox incidence in Kingdom of Bahrain”
Ui Yoon Choi
Clin Exp Pediatr. 2026;69(11):855-857.   Published online October 29, 2026
Bahrain’s experience suggests that routine varicella vaccination using a 2-dose schedule can substantially reduce the disease burden. In Korea, where a single-dose schedule has been used since 2005, breakthrough varicella remains common, and 1-dose vaccine effectiveness declines to approximately 50% by 6 years after vaccination. Findings from Bahrain, together with experiences from Germany and the United States, support the consideration of a routine second dose in Korea.
Original Article
Neurology
Prenatal stress via chronic immobilization amplifies N-methyl-D-aspartate-induced spasm-like seizure susceptibility and neuroinflammation in neonatal rats
Hyeok Hee Kwon, Seungyeon Bin, Seung Gyu Choi, Hyo Jung Shin, Joon Won Kang
Clin Exp Pediatr. 2026;69(11):858-867.   Published online September 8, 2026
Question: Does chronic prenatal immobilization stress increase an offspring's susceptibility to spasms, and is this associated with altered glial activation and gamma-aminobutyric acid (GABA)ergic signaling in the developing brain?
Finding: Prolonged prenatal stress increases susceptibility to N-methyl-D-aspartate-induced spasms, enhanced glial activation, and impaired GABAergic signaling.
Meaning: Long-term prenatal stress may promote early life epileptogenesis associated with neuroinflammation as well as disrupted inhibitory neurotransmission, although a causal role remains to be established.
General Pediatrics
Effect of varicella vaccine introduction on chickenpox incidence in Kingdom of Bahrain
Afaf Merza Mohamed, Hasan M. Isa, Malak Husain Hasan, Maram Husain Hasan, Ali K. Moosa, Janan Husain Radhi, Basma Al Saffar, Adel Al Sayyad
Clin Exp Pediatr. 2026;69(11):868-877.   Published online September 14, 2026
Question: What was the effect of varicella vaccine introduction on chickenpox incidence in Bahrain?
Finding: Postvaccine introduction in May 2015, new varicella cases declined substantially, particularly among children aged 0–9 years. Most cases are managed in primary healthcare settings, with rare hospitalizations and no reported deaths.
Meaning: Routine varicella vaccination is associated with reduced disease burden, demonstrating sustained high coverage, continued surveillance, and protection of susceptible groups.
Developmental and Behavioral Medicine
Association between maternal traumatic stress related to Great East Japan Earthquake and behavioral problems in offspring
Shun Tanabe, Masatsugu Orui, Chikana Kawaguchi, Genki Shinoda, Aoi Noda, Mami Ishikuro, Taku Obara, Shinichi Kuriyama
Clin Exp Pediatr. 2026;69(11):878-890.   Published online October 22, 2026
Association between maternal traumatic stress related to Great East Japan Earthquake and behavioral problems in offspringQuestion: Does prepregnancy maternal traumatic stress influence behavioral outcomes in early childhood?
Finding: Children born to mothers who reported greater disaster-related traumatic stress showed higher risks of internalizing, externalizing, and total behavioral problems at ages 2 and 3 years consistent with a dose-response relationship.
Meaning: Long-term maternal mental health support covering the broader reproductive period may play a role in addressing intergenerational behavioral problems after large-scale disasters.
Hematology
Hematological alterations in adolescent girls with restrictive anorexia nervosa and secondary amenorrhea at the time of diagnosis
Katarína Šebeková, Alexandra Gaál Kovalčíková, Ľubica Tichá, Ľudmila Podracká
Clin Exp Pediatr. 2026;69(11):891-901.   Published online October 19, 2026
Question: Do adolescent girls with restrictive anorexia nervosa and secondary amenorrhea have low blood counts at diagnosis?
Finding: Patients, even those with bone mineral density z scores similar to those of controls and adequate micronutrient levels, exhibited lower blood counts and suppressed bone formation and endocrine parameters compared with healthy age-matched controls.
Meaning: Hematological alterations may occur early in the disease course and complement routine clinical assessments.
Clinical Note
Cardiology
First biallelic CASQ2 variant in a Korean child with catecholaminergic polymorphic ventricular tachycardia
Sang Hun Jung, Shin Hyeung Kwak, Gwang Jun Choi, Ja-Kyoung Yoon, Jin Young Song, I Seok Kang, June Huh
Clin Exp Pediatr. 2026;69(11):902-905.   Published online September 1, 2026
Guideline
Oncology
Evidence-based clinical practice guidelines for pediatric hepatoblastoma: a systematic review and expert recommendations from Korea
Jin Kyung Suh, Jisun Hwang, Hee Mang Yoon, Kyong Ihn, Jung-Man Namgoong, Jeong A. Park, Jung-Sun Kim, Hyoung Soo Choi, Sung Hye Park, Dong Ah Park, Kyung-Nam Koh
Clin Exp Pediatr. 2026;69(11):912-924.   Published online October 23, 2026
This is the first Korean evidence-based clinical practice guideline for pediatric hepatoblastoma. Key recommendations include computed tomography and magnetic resonance imaging for PRETEXT (PRE-Treatment EXTent of disease) staging, cisplatin monotherapy for standard-risk disease, upfront surgery for resectable tumors, metastasectomy for residual lung lesions, and sodium thiosulfate for otoprotection. Well-differentiated fetal histology carries a favorable prognosis, whereas the small cell undifferentiated pattern requires immunohistochemical and molecular testing to exclude malignant rhabdoid tumor.
Correction
Author Correction: Linking pediatric obesity to youth-onset type 2 diabetes: integrated longitudinal and cross-sectional evidence from population-based studies worldwide
Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Mohamed, Ahmed Elawwa
Clin Exp Pediatr. 2026;69(11):925-926.   Published online October 22, 2026

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