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"Most downloaded" Articles are from the articles published in 2021 during the last six months.

Clinical Note
Endocrinology
Graves’ disease: an uncommon cause of late sequelae following DRESS (drug reaction with eosinophilia and systemic symptoms)   (60 times)
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
Editorial
Pulmonology
Wheezing in infants and preschoolers: phenotypes and treatment options   (60 times)
Jung Yeon Shim
Clin Exp Pediatr. 2023;66(1):26-27.   Published online December 6, 2022
· Knowing who will develop into asthma or who will not is important to impose proper treatment and early intervention in a child with the first episode of wheezing.
· Phenotypes of severe bronchiolitis in less than 2-year-old children with first episode of wheezing were suggested for different treatment options
· RV-induced and/or atopy-associated severe wheezing in preschool children may benefit from early intervention of asthma treatment.
Review Article
Nephrology (Genitourinary)
Obesity and chronic kidney disease: prevalence, mechanism, and management   (59 times)
Hyung Eun Yim, Kee Hwan Yoo
Clin Exp Pediatr. 2021;64(10):511-518.   Published online April 6, 2021
· Obesity is strongly associated with the development and progression of chronic kidney disease.
· Altered renal hemodynamics, metabolic effects, and lipid nephrotoxicity may play a key role in the development of obesity-related kidney disease.
· Children born to obese mothers are at increased risk of developing obesity and chronic kidney disease later in life.
· A multilevel approach is needed to prevent obesity and related chronic diseases.
Editorial
Pulmonology
Community-acquired pneumonia in Korean children: time to read between the lines   (59 times)
Dong In Suh
Clin Exp Pediatr. 2023;66(1):22-23.   Published online November 10, 2022
· Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children
· Factors other than etiology are equally important to a compre hensive understanding of CAP
· Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification
Review Article
Neurology
Promising candidate cerebrospinal fluid biomarkers of seizure disorder, infection, inflammation, tumor, and traumatic brain injury in pediatric patients   (58 times)
Seh Hyun Kim, Soo Ahn Chae
Clin Exp Pediatr. 2022;65(2):56-64.   Published online August 23, 2021
· 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.
Oncology
Application of 3-dimensional printing implants for bone tumors   (58 times)
Jong Woong Park, Hyun Guy Kang
Clin Exp Pediatr. 2022;65(10):476-482.   Published online December 23, 2021
∙ 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.
Cardiology
Diagnosis of coronary artery abnormalities in Kawasaki disease: recent guidelines and z score systems   (57 times)
Sung Hye Kim
Clin Exp Pediatr. 2022;65(9):430-438.   Published online December 17, 2021
∙ Kawasaki disease is the leading cause of acquired heart disease among children in the developed countries, and Korea has the second-highest incidence in the world.
∙ Early diagnosis and proper treatment are imperative to prevent coronary complication, and evaluation of coronary artery abnormalities is fundamental.
∙ Recent guidelines have adapted z score system for the diagnosis of coronary artery abnormalities in Kawasaki disease.
∙ Applying z score in diagnosis of coronary abnormalities has better correlation with clinical outcomes than absolute cutoff values.
∙ Calculated z scores could be different according to the z score formula, which might influence the treatment plan.
General Pediatrics
Motor performance of children with attention deficit hyperactivity disorder: focus on the Bruininks-Oseretsky Test of Motor Proficiency   (57 times)
Khushboo Prashant Adhvaryu, Suruliraj Karthikbabu, Pratiksha Tilak Rao
Clin Exp Pediatr. 2022;65(11):512-520.   Published online February 17, 2022
· Children with attention deficit hyperactivity disorder (ADHD) tend to have impaired motor performance that may affect their growth and development.
· Although widely used among children with developmental disorders, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) is used sparsely among children with ADHD.
· Assessment by the BOTMP increases our understanding of the motor repertoire of children with ADHD.
· Wider usage of the BOTMP will enable more comprehensive planning of rehabilitation goals to enhance the motor abilities of children with ADHD.
Nephrology (Genitourinary)
Neonatal hypertension: concerns within and beyond the neonatal intensive care unit   (57 times)
Kathleen Altemose, Janis M. Dionne
Clin Exp Pediatr. 2022;65(8):367-376.   Published online May 30, 2022
Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course.
Neurology
Myelin oligodendrocyte glycoprotein antibody-associated disorders: clinical spectrum, diagnostic evaluation, and treatment options   (56 times)
Yun-Jin Lee, Sang Ook Nam, Ara Ko, JuHyun Kong, Shin Yun Byun
Clin Exp Pediatr. 2021;64(3):103-110.   Published online May 14, 2020
MOG antibody-associated disorder exhibits different pathophysiological and phenotypic findings than both aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder and typical MS. MOG-antibody is of particular interest in pediatric patients with clinical or radiological non-MS typical findings. MOG-antibody was included in a diagnostic algorithm for children recommending for the first time a standardized use in clinical practice except in cases of typical MS.
Original Article
Neonatology (Perinatology)
Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial   (55 times)
Mohammad Kazem Sabzehei, Behnaz Basiri, Maryam Shokouhi, Sajad Ghahremani, Ali Moradi
Clin Exp Pediatr. 2022;65(4):188-193.   Published online July 28, 2021
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.
Review Article
Endocrinology
Endocrine comorbidities of pediatric obesity   (55 times)
Jieun Lee, Jae Hyun Kim
Clin Exp Pediatr. 2021;64(12):619-627.   Published online August 26, 2021
∙ Pediatric obesity can involve endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty.
∙ Prediabetes and type 2 diabetes in youth aged 10–19 years had a prevalence of 25.9% and 0.6% in 2013–2014, respectively.
∙ Dyslipidemia in Korean adolescents aged 10–18 years had a prevalence of 7.64% (total cholesterol ≥200 mg/dL), 6.09% (low-density lipoprotein cholesterol ≥130 mg/dL), 8.69% (triglyceride ≥150 mg/dL), and 12.52% (high-density lipoprotein cholesterol ≤40 mg/dL) in 2007–2018.
∙ Metabolic syndrome in Korean youth has a prevalence of 1.9%–14.7% in males and 1.7%–12.6% in females with wide variation in definitions.
∙ Appropriate comorbidity screening and management and/or specialist referral are necessary for obese children and adolescents.
Gastroenterology
Clinical importance of immunonutrition in infants: a review of the recent literature   (55 times)
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.
Original Article
Gastroenterology
Probiotics added to maternal nutrition affect ınfantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study   (55 times)
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.
Review Article
Allergy
Management of patients with allergic diseases in the era of COVID-19   (54 times)
Eun Lee
Clin Exp Pediatr. 2022;65(11):529-535.   Published online September 23, 2022
In the early days of the coronavirus disease 2019 (COVID-19) pandemic, allergic diseases, especially asthma, were considered to be risk factors for severe COVID-19 infection, hospitalization, and death. These concerns stemmed from the idea that individuals with allergic diseases are generally more susceptible to respiratory virus infections, which are major causes of exacerbation of allergic diseases. However, epidemiologic data with...
Clinical Note
Rheumatology
Haploinsufficiency A20 misdiagnosed as PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome with Kikuchi disease   (53 times)
Kyo Jin Jo, Su Eun Park, Chong Kun Cheon, Seung Hwan Oh, Seong Heon Kim
Clin Exp Pediatr. 2023;66(2):82-84.   Published online June 22, 2022
Original Article
Gastroenterology
Celiac disease in children: Increasing prevalence and changing clinical presentations   (52 times)
Hasan M. Isa, Eman Farid, Jaafar J. Makhlooq, Afaf M. Mohamed, Jumana G. Al-Arayedh, Fawzeya A. Alahmed, Shima Medani
Clin Exp Pediatr. 2021;64(6):301-309.   Published online October 17, 2020
Question: What are the prevalence and clinical characteristics of celiac disease (CD) in children in Bahrain?
Finding: We found a significant increase in CD prevalence over the last decade (P=0.0001). A male predominance was noted. Atypical presentations were common. Most patients had poor adherence to a gluten-free diet.
Meaning: CD is an underdiagnosed condition. Atypical symptoms should be considered to prevent missing patients with CD.
Oncology
Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand   (52 times)
Kunanya Suwannaying, Piti Techavichit, Patcharee Komvilaisak, Napat Laoaroon, Nattee Narkbunnam, Kleebsabai Sanpakit, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Lalita Sathitsamitphong, Chalongpon Santong, Panya Seksarn, Suradej Hongeng, Surapon Wiangnon
Clin Exp Pediatr. 2022;65(9):453-458.   Published online May 24, 2022
Question: This study aimed to elucidate the outcomes of high-risk neuroblastoma (HR-NB) patients treated with high-dose chemotherapy and stem cell rescue without immunotherapy.
Finding: The 5-year overall survival and event-free survival rates were 45.1% and 40.4%, respectively.
Meaning: High-dose chemotherapy plus stem cell rescue followed by cis-retinoic acid for 12 months is well tolerated and could improve survival in patients with HR-NB in limited resource settings.
Review Article
Nutrition
Total energy expenditure measured by doubly labeled water method in children and adolescents: a systematic review   (50 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.
Original Article
Neonatology (Perinatology)
A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants   (50 times)
Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun
Clin Exp Pediatr. 2023;66(1):32-37.   Published online December 15, 2022
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.
Review Article
Gastroenterology
Changing prevalence of Helicobacter pylori infection in children and adolescents   (49 times)
Ji Sook Park, Jin Su Jun, Ji-Hyun Seo, Hee-Shang Youn, Kwang-Ho Rhee
Clin Exp Pediatr. 2021;64(1):21-25.   Published online July 15, 2020
Although Helicobacter pylori infection rate in children is unclear due to diversity and limitation of diagnostic tests unlike in adults, investigation the childhood prevalence is important for predicting H. pylori-related diseases in the future.
H. pylori infection occurred in early childhood, and declined during 30 years in our study.
Change in risk factors of H. pylori transmission and consensus for eradication therapy in children might further reduce the infection rate.
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   (49 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
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.
Letter to the Editor
Developmental and Behavioral Medicine
The influence of parental eating behaviors, child-feeding practices, and infants’ temperaments upon infants’ eating behaviors   (49 times)
Goh Woon Lim, Kyoung Min Shin
Clin Exp Pediatr. 2022;65(9):466-468.   Published online June 27, 2022
Editorial
Gastroenterology
Ability of probiotics to reduce functional abdominal pain in children   (49 times)
Ji Sook Park
Clin Exp Pediatr. 2022;65(12):585-586.   Published online October 6, 2022
· The ability of probiotics to relieve pain caused by functional abdominal pain disorders (FAPD) in children is unclear.
· Lactobacillus reuteri may effectively reduce pain caused by childhood FAPD.
· Since the routine use of probiotics cannot be recommended due to a lack of clinical evidence, research into probiotic mixtures or symbiotics remains necessary.
Review Article
Infection
Updates on the coronavirus disease 2019 vaccine and consideration in children   (48 times)
Hyun Mi Kang, Eun Hwa Choi, Yae-Jean Kim
Clin Exp Pediatr. 2021;64(7):328-338.   Published online June 21, 2021
· The number of coronavirus disease 2019 cases has exponentially increased worldwide, and children ≤19 years old account for 11.0% of all confirmed cases.
· mRNA vaccines, BNT162b2 and mRNA-1273, and adenoviral vector vaccines, AZD1222 and Ad26.COV2.S, authorized for emergency use in the Emergency Use Listing of the World Health Organization are reviewed.
· Clinical trials of these vaccines have shown that they are safe and serious adverse reactions are rarely observed.
Therapeutics for the treatment of coronavirus disease 2019 in children and adolescents   (48 times)
Soo-Han Choi, Jae Hong Choi, Ki Wook Yun
Clin Exp Pediatr. 2022;65(8):377-386.   Published online June 27, 2022
· Children and adolescents with high risks for severe coronavirus disease 2019 (COVID-19) should be identified and proper treatment should be provided promptly according to the patient’s condition.
· Remdesivir can be considered for pediatric patients of all ages with COVID-19 who have an emergent or increase in supplemental oxygen.
· The use of corticosteroids is not recommended for patients with nonsevere COVID-19. Corticosteroids are recommended in children and adolescents with severe and critical COVID-19.
Original Article
General Pediatrics
Global relationship between parent and child obesity: a systematic review and meta-analysis   (47 times)
Ju Suk Lee, Mi Hyeon Jin, Hae Jeong Lee
Clin Exp Pediatr. 2022;65(1):35-46.   Published online March 29, 2021
Question: Are parent and child obesity correlated worldwide?
Finding: Overweight and obese status of parents and children were significantly associated worldwide. The association between parent and child obesity was stronger in Asia than in Europe and the Middle East, and in high-income than in middle- and low-income countries.
Meaning: Childhood obesity is highly influenced by parental weight status, indicating that parents could play an important role in its prevention.
Review Article
Neonatology (Perinatology)
Retinopathy of prematurity: a review of epidemiology and current treatment strategies   (47 times)
Eun Hee Hong, Yong Un Shin, Heeyoon Cho
Clin Exp Pediatr. 2022;65(3):115-126.   Published online October 12, 2021
There have been global tri-phasic epidemic periods of retinopathy of prematurity (ROP). In recent years, its incidence has reportedly been 10%–40% depending on country and study population. Current treatment strategies for ROP include laser photocoagulation, surgical treatment, and anti-vascular endothelial growth factor treatment, the role of which has drawn attention in recent years.
Original Article
Other
Risk factors and screening timing for developmental dysplasia of the hip in preterm infants   (47 times)
Ga Won Jeon, Hye Jung Choo, Yong Uk Kwon
Clin Exp Pediatr. 2022;65(5):262-268.   Published online November 5, 2021
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.
Review Article
Cardiology
Implication of microRNA as a potential biomarker of myocarditis   (47 times)
Jin-Hee Oh, Gi Beom Kim, Heeyoung Seok
Clin Exp Pediatr. 2022;65(5):230-238.   Published online March 2, 2022
· Myocarditis was recently examined quantitatively as inflammation of the heart muscle based on endomyocardial biopsy, and its noninvasive diagnosis remains unsatisfactory.
· Additionally, numerous miRNAs (miR-155, miR-146b, miR-590, miR-221, miR-222, etc.) coupled with inflammation or viral activation have been examined in myocarditis patients or mouse models.
· The recent identification of mmu-miR-721 (has-miR-Chr8: 96), a myocarditis-specific microRNA, demonstrated its potential as an acute myocarditis biomarker.
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