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Most-cited articles are from the articles published during the last two years (2022 ~ ).

Review Article
Gastroenterology
Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children
Yu Kyung Cho, Jin Lee, Chang Nyol Paik
Clin Exp Pediatr. 2023;66(9):377-383.   Published online August 21, 2023
· 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.
General Pediatrics
Korean Developmental Screening Test for Infants and Children (K-DST): development, applications, and implications for future early childhood development interventions
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
· 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.
Neonatology (Perinatology)
Neurodevelopmental outcomes of preterm infants
In Gyu Song
Clin Exp Pediatr. 2023;66(7):281-287.   Published online December 30, 2022
· 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.
Cardiology
Arrhythmia and COVID-19 in children
Mi Kyoung Song, Bryan Kwon
Clin Exp Pediatr. 2023;66(5):190-200.   Published online April 18, 2023
· Pediatric patients have a relatively low incidence of tachyarrhythmia both in acute coronavirus disease 2019 and multisystem inflammatory syndrome in children (MIS-C), but it was associated with an increased risk of poor outcomes.
· Conduction abnormalities were not uncommon, especially in those with MIS-C. Most patients recovered to normal sinus rhythm; however, some progressed to advanced atrioventricular block and rarely required permanent pacemaker implantation.
Gastroenterology
Liver fibrosis in children: a comprehensive review of mechanisms, diagnosis, and therapy
Elif Ozdogan, Cigdem Arikan
Clin Exp Pediatr. 2023;66(3):110-124.   Published online December 19, 2022
· 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.
Original Article
Neurobehavior
Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis
Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei
Clin Exp Pediatr. 2023;66(2):70-75.   Published online August 17, 2022
Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I2=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.
Review Article
Pulmonology
Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Eun Kyo Ha, Ju Hee Kim, Man Yong Han
Clin Exp Pediatr. 2023;66(11):465-474.   Published online June 19, 2023
· 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.
Nephrology (Genitourinary)
Kidney complications associated with COVID-19 infection and vaccination in children and adolescents: a brief review
Hee Sun Baek, Min Hyun Cho
Clin Exp Pediatr. 2023;66(10):424-431.   Published online June 28, 2023
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.
Cardiology
Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections
Young Hwan Lee
Clin Exp Pediatr. 2023;66(1):1-11.   Published online June 22, 2022
· 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.
Gastroenterology
Current diagnosis and image-guided reduction for intussusception in children
Jisun Hwang, Hee Mang Yoon, Pyeong Hwa Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho
Clin Exp Pediatr. 2023;66(1):12-21.   Published online July 4, 2022
· 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.
Original Article
Neurology
Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review
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
· 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.
Cardiology
Early myocardial functional abnormalities in primary dyslipidemia: clinical and echocardiographic observations in young children from a highly consanguineous population
Nehal M. El-koofy, Aya M. Fattouh, Areef Ramadan, Mohamed A. Elmonem, Dina H. Hamed
Clin Exp Pediatr. 2022;65(8):410-416.   Published online December 8, 2021
In children with primary dyslipidemia, functional myocardial abnormalities can occur at young age, including diastolic functional impairment of both ventricles and narrowing of the aortic valve and the sinus of Valsalva. Echocardiographic evaluations of high-risk children may be as important as biochemical evaluations.
Review Article
Gastroenterology
Clinical importance of immunonutrition in infants: a review of the recent literature
Ji Sook Park
Clin Exp Pediatr. 2022;65(7):337-343.   Published online February 17, 2022
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.
Editorial
Nutrition
Human milk oligosaccharides as immunonutrition key in early life
Jung Ok Shim
Clin Exp Pediatr. 2022;65(7):344-345.   Published online May 3, 2022
· Human milk is a major source of immunonutrients for neonates and infants. Human milk oligosaccharides (HMOs) act as prebiotics and promote the growth of commensal bacteria.
· HMOs inhibit microorganism adhesion to the gut mucosa through interactions with the commensal microbiome and improve gut barrier function by increasing short-chain fatty acid mediated by bifidobacteria and immunomodulation.
· Several randomized controlled trials recently reported on HMOs.
Original Article
Infection
Role of lung ultrasound patterns in monitoring coronavirus disease 2019 pneumonia and acute respiratory distress syndrome in children
Satyabrata Roychowdhoury, Subhajit Bhakta, Manas Kumar Mahapatra, Saptarshi Ghosh, Sayantika Saha, Mithun Chandra Konar, Mihir Sarkar, Mousumi Nandi
Clin Exp Pediatr. 2022;65(7):358-366.   Published online May 13, 2022
Question: Potential role of patterns of lung ultrasonography (US) in monitoring changes in mechanically ventilated patients with coronavirus disease 2019 (COVID-19) pneumonia.
Finding: Interstitial syndrome, an irregular pleural line, and peripheral microconsolidation were the most prevalent findings. Changes in lung aeration after mechanical ventilation corelated with improved oxygenation. A fall in lung ultrasound reaeration score ≤ 5 may predict successful weaning.
Meaning: Lung US is gaining wider utility for monitoring COVID-19 pneumonia.
General Pediatrics
Effect of 2–6 weeks of systemic steroids on bone mineral density in children
Athira Kuniyil, Somdipa Pal, Namrita Sachdev, Tribhuvan Pal Yadav
Clin Exp Pediatr. 2022;65(5):254-261.   Published online November 18, 2021
Question: Does steroid use for 2–6 weeks in children affect bone mineral content (BMC) or density (BMD)?
Finding: Steroid use for 2–6 weeks significantly decreased BMC and BMD of the whole body, total body less the head, lumbar spine, and distal radius. A significant negative correlation was observed among BMD, duration, and cumulative dose.
Meaning: Steroid use for 2–6 weeks in children negatively affected BMC and BMD.
Review Article
Other
Knowledge-guided artificial intelligence technologies for decoding complex multiomics interactions in cells
Dohoon Lee, Sun Kim
Clin Exp Pediatr. 2022;65(5):239-249.   Published online November 26, 2021
· The need for data-driven modeling of multiomics interactions was recently highlighted.
· Many artificial intelligence-driven models have been developed, but only a few have incorporated biological domain knowledge within model architectures or training procedures.
· Here we provide a comprehensive review of deep learning models to decipher complex multiomics interactions regarding the biological guidance imposed upon them to facilitate further development of biological knowledge-guided deep learning models.
Neonatology (Perinatology)
Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
Ga Won Jeon
Clin Exp Pediatr. 2022;65(4):182-187.   Published online October 18, 2021
· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations.
· Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age.
· Platelet counts are positively correlated with gestational age at birth and postnatal age.
· Thrombocytosis is more common in preterm than in term infants.
· Thrombocytosis in newborns is reactive and resolves spontaneously without complications.
Clinical note
General Pediatrics
Diabetic ketoacidosis in children induced by coronavirus disease 2019 (COVID-19) diabetic ketoacidosis post-COVID-19 in children
Neha Thakur, Narendra Rai
Clin Exp Pediatr. 2022;65(4):209-210.   Published online November 30, 2021
Editorial
Endocrinology
Clinical and diagnostic importance of dyslipidemia in children and adolescents during the coronavirus disease 2019 pandemic
Eun Young Kim
Clin Exp Pediatr. 2022;65(3):129-130.   Published online January 14, 2022
∙ Because childhood lipid concentrations continue into adulthood, early evaluation and treatment are needed, but dyslipidemia awareness is low.
∙ For the prevention and treatment of dyslipidemia in childhood and adolescence, a major risk factor for cardiovascular disease in adulthood, lifestyle modifications, appropriate exercise, and drug treatment are required.
∙ A large-scale study of the prevalence and therapeutic effects of dyslipidemia in children and adolescents in Korea is needed.
Clinical Note
Endocrinology
Graves’ disease: an uncommon cause of late sequelae following DRESS (drug reaction with eosinophilia and systemic symptoms)
Therdpong Tempark, Amatanun Tangthanapalakul, Tawatchai Deekajorndech, Susheera Chatproedprai, Vichit Supornsilchai, Siriwan Wananukul
Clin Exp Pediatr. 2022;65(12):602-604.   Published online June 22, 2022
Review Article
Neonatology (Perinatology)
Neonatal seizures: stepping outside the comfort zone
Menna Hashish, Mohamed Reda Bassiouny
Clin Exp Pediatr. 2022;65(11):521-528.   Published online April 4, 2022
· 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.
Perspective
Infection
Statement on healthcare system preparedness in response to COVID-19 Omicron subvariants BA.4 and BA.5 surge in Korea from the Korean Pediatric Society and Korean Society of Pediatric Infectious Diseases
Eun Young Cho, Dong Hyun Kim, Soo-Han Choi, Ki Wook Yun, Jong Gyun Ahn, Hye-Kyung Cho, Hyunju Lee, Jina Lee, Taek-Jin Lee, Byung-Wook Eun, Jin Lee, Dae Sun Jo, Yun-Kyung Kim, Yae-Jean Kim; Committee on Infectious Diseases of the Korean Pediatric Society
Clin Exp Pediatr. 2022;65(11):510-511.   Published online September 23, 2022
In order to respond to the recent surge in coronavirus disease 2019 (COVID-19) cases and the continuously changing epidemiology of COVID-19, a sustainable and flexible pediatric healthcare system must be prepared considering the specificity of pediatric care. We demand a more proactive response from the health authorities to check the current state of pediatric COVID-19 patient care and to ensure that pediatric patients receive appropriate and timely management.
Original Article
Gastroenterology
Probiotics added to maternal nutrition affect ınfantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study
Aysu Yıldız Karaahmet, Gülümser Dolgun, Metehan Özen
Clin Exp Pediatr. 2022;65(11):547-554.   Published online September 23, 2022
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.
Editorial
Nephrology (Genitourinary)
Hypertension in adulthood is programmed during the perinatal period
Min Hyun Cho
Clin Exp Pediatr. 2022;65(10):494-495.   Published online August 12, 2022
∙ Intrauterine growth restriction (IUGR) and preterm birth can be significant risk factors for the development of adult hypertension.
∙ Several perinatal factors of hypertension are related to IUGR, including renal, vascular, and rapid catch-up growth.
Letter to the Editor
Cardiology
Early prophylaxis of cardiomyopathy with beta-blockers and angiotensin receptor blockers in patients with Duchenne muscular dystrophy
Heirim Lee, Jinyoung Song, I-Seok Kang, June Huh, Jin A Yoon, Yong Beom Shin
Clin Exp Pediatr. 2022;65(10):507-509.   Published online August 22, 2022
Review Article
Gastroenterology
Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clin Exp Pediatr. 2022;65(1):21-28.   Published online September 10, 2021
· 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.
Allergy
Moderate to severe atopic dermatitis in children: focus on systemic Th2 cytokine receptor antagonists and Janus kinase inhibitors
Jeong Hee Kim, Mona Salem Samra
Clin Exp Pediatr. 2024;67(2):64-79.   Published online June 14, 2023
· Atopic dermatitis (AD) is characterized by a strong T helper (Th)2 response, although the extents of Th22, Th17/ interleukin (IL)-23, and Th1 responses vary among disease subtypes.
· Children with moderate to severe AD may require early systemic therapy to reduce the systemic inflammation caused by increased Th2 cytokine levels.
· Dupilumab, which blocks IL-4/IL-13 receptor, has equivalent efficacy for extrinsic and intrinsic AD and a favorable safety profile in infants and children aged 6 months and older.
Developmental and Behavioral Medicine
Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates
Tae Hoon Eom, Young-Hoon Kim
Clin Exp Pediatr. 2024;67(1):26-34.   Published online June 14, 2023
· 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.
Infection
COVID-19 among infants: key clinical features and remaining controversies
Nevio Cimolai
Clin Exp Pediatr. 2024;67(1):1-16.   Published online November 27, 2023
· 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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