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Most-cited articles are from the articles published during the last two years (2023 ~ ).
- Review Article
- Neonatology (Perinatology)
- Neurodevelopmental outcomes of preterm infants
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In Gyu Song
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Clin Exp Pediatr. 2023;66(7):281-287. Published online December 30, 2022
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· Among survivors, 60.9% of infants born at 22 weeks’ gestation had moderate to severe impairments, whereas 50.3% born at 23 weeks’ and 42.2% at 24 weeks’ gestation had moderate to severe impairments.
· Moderate and late preterm infants reportedly have less severe disease than very preterm infants, but they still experience adverse neurodevelopmental outcomes.
· The careful follow-up and early detection of developmental problems in these patients are required. |
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- Pulmonology
- Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
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Eun Kyo Ha, Ju Hee Kim, Man Yong Han
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Clin Exp Pediatr. 2023;66(11):465-474. Published online June 19, 2023
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· Current definitions of long coronavirus disease (COVID) in children and adolescents vary in duration, ranging from 4 to 12 weeks or more.
· The clinical spectrum of long COVID in children and adolescents comprises a wide range of symptoms and might be a multisystem disorder.
· Persistent health problems with a prevalence of 1%–66.5% were reported in children and adolescents after COVID-19, with a higher incidence of persistent single or multiple symptoms. |
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- Endocrinology
- Nonalcoholic fatty liver disease and insulin resistance in children
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Kyungchul Song, Ho-Seong Kim, Hyun Wook Chae
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Clin Exp Pediatr. 2023;66(12):512-519. Published online January 9, 2023
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· 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. |
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- Nutrition
- Association of gut microbiota with obesity in children and adolescents
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Ky Young Cho
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Clin Exp Pediatr. 2023;66(4):148-154. Published online November 16, 2022
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The gut microbiota is an emerging factor in the development of pediatric obesity, which is affected by renowned risk factors such as diet, lifestyle, and socioeconomic status. This review aimed to describe the association between the gut microbiota and childhood obesity. |
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- Original Article
- Neonatology (Perinatology)
- Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
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Asha P. Shetty, Kurvatteppa Halemani, Alwin Issac, Latha Thimmappa, Sanjay Dhiraaj, Radha K, Prabhaker Mishra, Vijai Datta Upadhyaya
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Clin Exp Pediatr. 2024;67(2):104-115. Published online November 14, 2023
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Question: What emotions do parents experience when their newborns are admitted to the neonatal intensive care unit (NICU)?
Finding: Mothers experienced more anxiety (51%), depression (31%), and stress (41%) symptoms than fathers (26%, 12%, and 22%, respectively).
Meaning: Parents often experience anxiety, stress, and depression following NICU admission. Healthcare workers are responsible for providing regular parental counseling. |
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- Review Article
- Neurology
- Gut microbiota affects brain development and behavior
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Gun-Ha Kim, Jung-Ok Shim
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Clin Exp Pediatr. 2023;66(7):274-280. Published online November 8, 2022
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· The gut microbiota can alter a host’s brain development and behavior.
· Gut bacteria communicate with the brain via the microbiota-gut-brain axis.
· Fecal microbial transplantation is a promising treatment strategy for autism spectrum disorder. |
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- Allergy
- Natural course of IgE-mediated food allergy in children
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Kyunguk Jeong, Sooyoung Lee
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Clin Exp Pediatr. 2023;66(12):504-511. Published online June 14, 2023
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· 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. |
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- Gastroenterology
- Liver fibrosis in children: a comprehensive review of mechanisms, diagnosis, and therapy
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Elif Ozdogan, Cigdem Arikan
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Clin Exp Pediatr. 2023;66(3):110-124. Published online December 19, 2022
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· Chronic liver diseases in children are heterogenous but converge in the common pathway of fibrosis.
· Much of the literature on mechanisms of fibrogenesis focus on adults but pediatric physiology has documented differences.
· Understanding of these distinctions are necessary to define, treat, and prevent fibrosis.
· Current management of liver fibrosis relies heavily on liver biopsy. Multiple tools have shown high diagnostic performance in pediatric and adult populations. Large, multicenter studies are needed for validation. |
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- Infection
- Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment
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Ki Wook Yun
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Clin Exp Pediatr. 2024;67(2):80-89. Published online June 14, 2023
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· Most commonly confirmed causes of community-acquired pneumonia (CAP) in children are Mycoplasma pneumoniae (8%–40%) and respiratory syncytial virus (15%–20%).
· Pyogenic bacteria, most commonly Streptococcus pneumoniae (40%–50%) and Streptococcus pyogenes (10%–25%), are detected in 2%–5% of children hospitalized with CAP.
· CAP should be diagnosed conservatively according to clinical and radiological criteria.
· The etiology should be identified via appropriate test result interpretation. |
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- Other
- Hearing loss in neonates and infants
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Goun Choe, Su-Kyoung Park, Bong Jik Kim
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Clin Exp Pediatr. 2023;66(9):369-376. Published online January 9, 2023
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· 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. |
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- Neurology
- Electroencephalography source localization
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Tae-Hoon Eom
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Clin Exp Pediatr. 2023;66(5):201-209. Published online December 29, 2022
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· Electroencephalography (EEG) directly images the electrical activity of neurons at a higher temporal resolution than other neuroimaging techniques.
· EEG is still widely used in brain function research due to its advantages.
· Forward and inverse problems of EEG analyses require solutions.
· Methods such as the dipole and distributed source models have been introduced.
· Applications of EEG are expanding with the integration of other technologies and large-scale data. |
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- Infection
- COVID-19 in immunocompromised children and adolescents
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Byung Ok Kwak, Byung Wook Eun
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Clin Exp Pediatr. 2023;66(5):182-189. Published online April 18, 2023
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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. |
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- Pathogenetic and etiologic considerations of febrile seizures
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Ji Yoon Han, Seung Beom Han
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Clin Exp Pediatr. 2023;66(2):46-53. Published online January 13, 2023
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· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures. |
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- Genetics and Metabolism
- Development of orphan drugs for rare diseases
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Han-Wook Yoo
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Clin Exp Pediatr. 2024;67(7):315-327. Published online June 28, 2023
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· Orphan disease is a rare disease, primarily affecting newborn and children. Vast majority of orphan diseases has genetic background.
· Orphan disease is individually rare. But as a whole, it is not rare, becoming a great socioeconomic burden.
· The diagnosis of rare genetic disease has been problematic, but recent progress of genome analysis technologies makes it faster and more precise.
· There are many unmet needs as to the curative treatment. However, the number of treatable rare diseases is growingly increasing owing to the development of biotechnology.
· Most orphan drugs are extremely expensive because of numer ous hurdles during the process of drug development as well as small number of patients. |
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- General Pediatrics
- Metabolic complications of obesity in children and adolescents
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Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park
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Clin Exp Pediatr. 2024;67(7):347-355. Published online November 16, 2023
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· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity. |
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- Gastroenterology
- Current diagnosis and image-guided reduction for intussusception in children
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Jisun Hwang, Hee Mang Yoon, Pyeong Hwa Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho
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Clin Exp Pediatr. 2023;66(1):12-21. Published online July 4, 2022
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· 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. |
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- Neonatology (Perinatology)
- Treatment of congenital cytomegalovirus infection
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Gyu Hong Shim
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Clin Exp Pediatr. 2023;66(9):384-394. Published online December 28, 2022
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· 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. |
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- Cardiology
- Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections
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Young Hwan Lee
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Clin Exp Pediatr. 2023;66(1):1-11. Published online June 22, 2022
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· 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. |
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- Original Article
- Nutrition
- Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis
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Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Salman Khazaei
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Clin Exp Pediatr. 2023;66(1):28-31. Published online July 19, 2022
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This study aimed to determine whether there is an association between not breastfeeding (versus breastfeeding) and the risk of autism spectrum disorders (ASD) among children. We found that the risk of ASD associated with not breastfeeding had an odds ratio of 1.81 (95% confidence interval, 1.35–2.27; I2=0 %). These findings suggest the importance of breastfeeding in decreasing the risk of ASD among children. |
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- Review Article
- Allergy
- Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis
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Kiwako Yamamoto-Hanada, Yukihiro Ohya
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Clin Exp Pediatr. 2024;67(10):477-485. Published online June 14, 2023
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To prevent food allergy in infants, based on the dual allergen exposure hypothesis, we recommend a personalized approach consisting of both skin intervention (eczema treatment to achieve early remission and well-controlled skin without eczema to prevent percutaneous immunoglobulin E sensitization) and oral intervention (early allergenic food introduction). |
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- Developmental and Behavioral Medicine
- Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates
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Tae Hoon Eom, Young-Hoon Kim
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Clin Exp Pediatr. 2024;67(1):26-34. Published online June 14, 2023
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· Primary pediatricians should play a key role in the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD).
· The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has lowered the diagnostic threshold for older teens and adults and a comorbid diagnosis with autism is now allowed.
· The American Academy of Pediatrics had added recommendation-related comorbid conditions in its guideline and the Society of Developmental and Behavioral Pediatrics recently developed a complex ADHD guideline.
· The European ADHD Guideline Group recently developed a guideline for managing ADHD during the coronavirus disease 2019 pandemic. |
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- Original Article
- Allergy
- Association between dyslipidemia and asthma in children: a systematic review and multicenter cohort study using a common data model
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Ji Eun Lim, Hye Min Kim, Ju Hee Kim, Hey Sung Baek, Man Yong Han
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Clin Exp Pediatr. 2023;66(8):357-365. Published online June 14, 2023
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Question: Is dyslipidemia a risk factor for asthma in children?
Finding: This was a comprehensive systematic review and retrospective multicenter study of the association between dyslipidemia and asthma in children. In a multicenter cohort analysis using the Observational Medical Outcomes Partnership Common Data Model, elevated total cholesterol levels were associated with increased risk of asthma development.
Meaning: These findings suggest an association between dyslipidemia and asthma in children. |
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- Neonatology (Perinatology)
- Efficacy of body position on gastric residual in preterm infant: a systematic review and meta-analysis
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Kurvatteppa Halemani, Alwin Issac, Sanjay Dhiraaj, Prabhaker Mishra
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Clin Exp Pediatr. 2023;66(6):262-270. Published online November 30, 2022
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Breastfeeding and it's tolerance are the positive indicators for preterm babies. Placing the preterm infant in the right lateral or prone position after feed had lesser gastric residual volume compared to placing them in left lateral or supine positions. The post-feed position is a vital element in enhancing feeding tolerance, mechanical functions of the gastrointestinal tract and the overall development of preterm infants. |
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- Review Article
- Other
- Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies
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Rogers Wainkwa Chia, Ntegang Venant Atem, Jin-Yong Lee, Jihye Cha
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Clin Exp Pediatr. 2025;68(1):1-15. Published online November 6, 2024
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· Milk and formula are common sources of microplastic in infants.
· Water and air are the most common sources of microplastic pollution from infancy to adolescence.
· Microplastic use by children of all ages can cause cell damage and affect their health.
· Microplastics present in children can be quantified using a stereomicroscope and characterized using micro- Fourier transform infrared spectroscopy. |
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- Use of virtual reality in children in a broad range of medical settings: a systematic narrative review of recent meta-analyses
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Emily Antonovics, Grammatina Boitsios, Thomas Saliba
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Clin Exp Pediatr. 2024;67(6):274-282. Published online May 21, 2024
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· Virtual reality (VR) is becoming increasingly common for entertainment and in medical settings.
· VR is useful for treating children with cerebral palsy.
· VR can help with attention deficit/hyperactivity disorder symptoms.
· VR can decrease pain perception in children undergoing burn wound care.
· VR can reduce preoperative anxiety.
· VR can reduce fear and pain during needle-involving procedures. |
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- Gastroenterology
- Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children
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Yu Kyung Cho, Jin Lee, Chang Nyol Paik
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Clin Exp Pediatr. 2023;66(9):377-383. Published online August 21, 2023
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· 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. |
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- Editorial
- Immunology
- Systemic autoinflammatory disorders: autoinflammatory and autoimmune disorders
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Young Dae Kim
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Clin Exp Pediatr. 2023;66(10):439-440. Published online July 4, 2023
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· Systemic autoinflammatory disorders (SAIDs) typically have an early onset in life, and may have close relatives may have similar disease.
· SAIDs should be suspected in any patient, especially children, who experience persistent or recurrent inflammatory episodes that fail to fit the pattern of other established diseases.
· Advancements in the understanding of autoinflammation will provide novel diagnostic and therapeutic options for SAIDs patients. |
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- Review Article
- Neonatology (Perinatology)
- Neonatal family-centered care: evidence and practice models
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Juyoung Lee
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Clin Exp Pediatr. 2024;67(4):171-177. Published online June 14, 2023
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· Concrete evidence exists of early parent-infant attachment supported by family-centered care (FCC) in the neonatal intensive care unit.
· FCC involves the parents’ presence and participation in the infant’s care and decision-making.
· A private and comfortable space should be provided. A single-family room is ideal; however, a quiet space with a recliner can be a good alternative.
· Care culture changes and staff training are required. |
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- Infection
- COVID-19 among infants: key clinical features and remaining controversies
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Nevio Cimolai
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Clin Exp Pediatr. 2024;67(1):1-16. Published online November 27, 2023
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· Clinical studies of coronavirus disease 2019 (COVID-19) in infants should be supported by rigorous laboratory diagnostic criteria.
· Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads to infants similarly to other viral respiratory infections.
· Among infants ≤1 year of age beyond the immediate postpartum period, COVID-19 is relatively mild, but even the low risk of severe disease requires prevention.
· Comorbidities increase infection vulnerability and complications in infants.
· Clinical and laboratory data do not sufficiently distinguish COVID-19 from other respiratory viral infections.
· Coinfection with SARS-CoV-2 is uncommon among infants.
· Unique infection sequelae, including multi-inflammatory syndrome in children and neonates and long COVID require further study and refinement of diagnostic criteria.
· Infection control standards applied to mother-infant dyads should be tempered by standard preventive strategies, maternal input, accommodation potential, and overall safety.
· Maternal vaccination prevents disease in early infancy. |
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