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

Review Article
Gastroenterology
Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents   (35 times)
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.
Original Article
General Pediatrics
Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital   (35 times)
J. Jenifer Florence Mary, R. Sindhuri, A. Arul Kumaran, Amol R. Dongre
Clin Exp Pediatr. 2022;65(4):201-208.   Published online October 18, 2021
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...
Editorial
Emergency Medicine
Current diagnosis and image-guided reduction for intussusception in children: teamwork approach   (35 times)
Ji-Hyun Seo
Clin Exp Pediatr. 2023;66(2):66-67.   Published online September 1, 2022
· The successful and safe enema reduction of intussusception depends primarily on the experience and preference of the radiologists and the availability of resources.
· The establishment of a standardized manual or protocol for reduction and pre-reduction treatment of intussusception, along with the collaboration of pediatricians, radiologists, and surgeons, is expected to improve the treatment success rate.
Review Article
Nutrition
Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data   (34 times)
Minji Kang, So Yoon Choi, Minyoung Jung
Clin Exp Pediatr. 2021;64(9):443-458.   Published online December 28, 2020
In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk...
Nephrology (Genitourinary)
Blood pressure measurements and hypertension in infants, children, and adolescents: from the postmercury to mobile devices   (34 times)
Seon Hee Lim, Seong Heon Kim
Clin Exp Pediatr. 2022;65(2):73-80.   Published online September 15, 2021
· Hypertension is defined as a blood pressure (BP) >90th (elevated) or 95th (hypertension) percentile in children by height, age, and sex and >95th percentile in neonates by age, birth weight, and sex.
· Although the oscillometric method can be used for screenings, the auscultatory method remains the gold standard. The hybrid method employs the auscultatory and electronic methods and can reduce bias.
· BP measurement mobile device applications have a potential for development.
Editorial
Cardiology
Early echocardiographic screening for subclinical myocardial dysfunction in children and adolescents with dyslipidemia: why and when?   (34 times)
Hyun Gyung Lee, Hwa Jin Cho
Clin Exp Pediatr. 2022;65(8):398-400.   Published online March 7, 2022
Dyslipidemia contributes to early atherosclerosis, premature cardiovascular disease, and subclinical ventricular dysfunction in children. This paper highlights the need for echocardiographic evaluation for impaired diastolic function of both ventricles and narrowing of the aortic valve and sinus of Valsalva. Therefore, early echocardiographic screening of children with primary hyperlipidemia should be considered.
Review Article
Gastroenterology
Causes of acute gastroenteritis in Korean children between 2004 and 2019   (33 times)
Eell Ryoo
Clin Exp Pediatr. 2021;64(6):260-268.   Published online September 18, 2020
· Norovirus is the most common virus in Korean children with acute gastroenteritis.
· Escherichia coli and Salmonella spp. are the most common cause of bacterial gastroenteritis in Korean children, with a detection rate of 3%–20%.
· Uncommon bacterial and parasitic gastroenteritis require attention because of increasing international exchange and overseas travel.
Critical Care Medicine
Pediatric postintensive care syndrome: high burden and a gap in evaluation tools for limited-resource settings   (33 times)
Chanapai Chaiyakulsil, Rapee Opasatian, Paweethida Tippayawong
Clin Exp Pediatr. 2021;64(9):436-442.   Published online December 18, 2020
Pediatric postintensive care syndrome has high impact and burden and can affect a child’s life for decades. The early evaluation and detection of such problems require a simple and less time-consuming surveillance tool. Current evaluation tools can be difficult and strenuous for areas with limited resources. Thus, a new simple tool is required for the early detection and intervention of postintensive care syndrome in critically ill children
Original Article
Critical Care Medicine
Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?   (33 times)
Chanapai Chaiyakulsil, Onsuthi Pharadornuwat
Clin Exp Pediatr. 2021;64(3):123-129.   Published online July 14, 2020
Question: Can central line bundles and feedback reduce central line-associated complications in pediatric patients?
Finding: The central line-related bloodstream infection rate decreased from 10.0 catheter-days to 1.4/1,000 catheter-days at 6-month postintervention. The central line occlusion rate was also decreased.
Meaning: Reinforcing central line care bundles with direct feedback can significantly decrease central line-associated complications in pediatric patients.
Gastroenterology
Ability of polymicrobial probiotic and mono-strain probiotic to reduce functional abdominal pain in children: a randomized clinical trial   (33 times)
Seyed Sajad Jafari, Seyed Mojtaba Hashemi, Bahman Sadeghi, Amir Almasi-Hashiani
Clin Exp Pediatr. 2022;65(12):589-594.   Published online October 31, 2022
· This study compared the ability of 2 probiotics to reduce and improve functional abdominal pain (FAP) in children.
· In the polymicrobial probiotic (PMP) group, 10.34% of children reported no pain; in the mono-strain probiotic (MSP) group, all patients reported low-degree pain. The mean pain score decreased significantly over time in both groups.
· The use of both PMP and MSP is recommended to reduce pain in patients with FAP.
Review Article
Genetics and Metabolism
Neurofibromatosis type I: points to be considered by general pediatricians   (32 times)
Eungu Kang, Hee Mang Yoon, Beom Hee Lee
Clin Exp Pediatr. 2021;64(4):149-156.   Published online July 15, 2020
Neurofibromatosis type 1 (NF1), a prevalent genetic disease that is transmitted in an autosomal dominant manner, is characterized by multiple cutaneous café-au-lait spots and neurofibromas as well as various degrees of neurological, skeletal, and neoplastic manifestations. The clinical features of NF1 increase in frequency with age, while the clinical diagnosis can remain undetermined in some pediatric patients. Importantly, affected patients...
Original Article
General Pediatrics
Significance of the tethered maxillary frenulum: a questionnaire-based observational cohort study   (32 times)
Sody A. Naimer, Ariel Israel, Aviezer Gabbay
Clin Exp Pediatr. 2021;64(3):130-135.   Published online September 7, 2020
Question: Does a tethered maxillary frenulum in the newborn result in breastfeeding difficulty or other oral symptomatology?
Finding: The analysis of subjects with a tethered maxillary frenulum surveyed beyond a mean 5-year follow-up did not reveal an increase in oral issues versus those of a random agematched control group.
Meaning: These data demonstrate no need to intervene upon the diagnosis of a tethered maxillary frenulum.
Infection
Febrile urinary tract infection in children: changes in epidemiology, etiology, and antibiotic resistance patterns over a decade   (32 times)
Woosuck Suh, Bi Na Kim, Hyun Mi Kang, Eun Ae Yang, Jung-Woo Rhim, Kyung-Yil Lee
Clin Exp Pediatr. 2021;64(6):293-300.   Published online October 14, 2020
Question: How has the antibiotic susceptibility of urinary pathogens changed and what does it imply?
Finding: A yearly increase in multidrug-resistant and extended-spectrum β-lactamase (ESBL)–producing pathogens was observed. A higher recurrence rate was observed in cases of febrile urinary tract infection caused by ESBL producers in patients with underlying vesicoureteral reflux (VUR).
Meaning: The initial empirical antibiotic should reflect the changing susceptibility patterns and underlying VUR status.
Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis   (32 times)
Farhad Sarrafzadeh, Seyed Mojtaba Sohrevardi, Hamid Abousaidi, Hossein Mirzaei
Clin Exp Pediatr. 2021;64(8):415-421.   Published online November 20, 2020
The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran.
Review Article
Neurology
Recent trends of healthcare information and communication technologies in pediatrics: a systematic review   (32 times)
Se young Jung, Keehyuck Lee, Hee Hwang
Clin Exp Pediatr. 2022;65(6):291-299.   Published online December 15, 2021
· 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.
Recent update on reading disability (dyslexia) focused on neurobiology   (31 times)
Sung Koo Kim
Clin Exp Pediatr. 2021;64(10):497-503.   Published online March 2, 2021
·Neurobiological studies using functional brain imaging have uncovered the reading pathways, brain regions involved in reading, and neurobiological abnormalities of dyslexia.
·An accurate diagnosis and timely specialized intervention are important in children with dyslexia. When national infant development screening tests have been conducted as in Korea, if a language developmental delay and early predictors of dyslexia are detected, the progression to dyslexia should be carefully observed and early intervention provided.
Original Article
Nephrology (Genitourinary)
Urinary neutrophil gelatinase-associated lipocalin: a marker of urinary tract infection among febrile children   (31 times)
Ji Hyun Moon, Kee Hwan Yoo, Hyung Eun Yim
Clin Exp Pediatr. 2021;64(7):347-354.   Published online October 17, 2020
Question: Reliably diagnosing urinary tract infection (UTI) in febrile children is often difficult. Can urinary neutrophil gelatinase-associated lipocalin (uNGAL) better predict UTI and acute pyelonephritis (APN) than serum C-reactive protein (CRP) and white blood cell (WBC) count?
Finding: uNGAL better facilitated the prediction of UTI and APN, than serum CRP and WBC counts in febrile children.
Meaning: uNGAL is a suitable biomarker for UTI and APN in febrile children.
Original article
Infection
The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis   (31 times)
Behnam Abedi, Mehran Akbari, Sahar KhodaShenas, Alireza Tabibzadeh, Ali Abedi, Reza Ghasemikhah, Marzieh Soheili, Shnoo Bayazidi, Yousef Moradi
Clin Exp Pediatr. 2021;64(11):575-581.   Published online February 5, 2021
Is the global prevalence of toxocariasis high among children? The prevalence of toxocariasis is high in pediatric patients. Asian children are more susceptible to the disease than other children. Its virulence varies among different socioeconomic classes in various countries. Hand washing after soil contact, routine pet deworming, and appropriate disposal of pet feces in households with Asian pediatrics are needed to prevent toxocariasis.
Review Article
Infection
Four months of rifampicin monotherapy for latent tuberculosis infection in children   (31 times)
Chi Eun Oh, Dick Menzies
Clin Exp Pediatr. 2022;65(5):214-221.   Published online October 29, 2021
· Recently, the importance of a short-term treatment regimen including rifamycin has been highlighted in the treatment of latent tuberculosis infection (LTBI).
· Four prospective or retrospective studies in children consistently reported that a 4-month daily rifampicin regimen (4R) had a higher completion rate than and comparable safety to a nine-month daily isoniazid regimen.
· We suggest rifampicin 20–30 mg/kg/day for children aged 0–2 years and 15–20 mg/kg/day for children aged 2–10 years in 4R to treat LTBI.
Other
Knowledge-guided artificial intelligence technologies for decoding complex multiomics interactions in cells   (31 times)
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.
Editorial
Cardiology
Characteristics of z score systems for diagnosing coronary abnormalities in Kawasaki disease   (31 times)
Gyeong-Hee Yoo
Clin Exp Pediatr. 2022;65(9):448-449.   Published online March 14, 2022
Because of the various body sizes of children with Kawasaki disease (KD), coronary artery diameter requires normalization to the body surface area as a z score.
In updated guidelines, coronary artery abnormalities are important criteria in the diagnosis of KD, and z score systems have been accepted to define coronary artery abnormalities.
However, the z score formula should be selected carefully because each yields different results.
Neonatology (Perinatology)
Does cord blood cortisol have a mediating effect on maternal prepregnancy body mass index and birth weight?   (31 times)
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(1):24-25.   Published online November 30, 2022
· A high prepregnancy body mass index (pre-BMI) is associated with large for gestational age (LGA) and macrosomia, whereas a low pre-BMI is associated with small for gestational age (SGA) and low birth weight (LBW).
· The identification of the role of the hypothalamus-pituitary-adrenal axis in the effect of pre-BMI and maternal gestational weight gain on birth weight could reduce the frequency of LGA, macrosomia, SGA, or LBW through maternal diet optimization.
Letter to the Editor
Critical Care Medicine
Role of serum bilirubin-to-albumin ratio as a prognostic index in critically ill children   (31 times)
You Min Kang, Ga Eun Kim, Mireu Park, Jong Deok Kim, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Son, Soo Yeon Kim
Clin Exp Pediatr. 2023;66(2):85-87.   Published online December 5, 2022
Original Article
Nutrition
Impact of preoperative nutritional status on surgical outcomes in patients with pediatric gastrointestinal surgery   (30 times)
Nehal El Koofy, Hadeer Mohamed Nasr Eldin, Wesam Mohamed, Mostafa Gad, Sara Tarek, Gamal El Tagy
Clin Exp Pediatr. 2021;64(9):473-479.   Published online November 16, 2020
Question: Is malnutrition a risk factor for postoperative complications in pediatric surgical patients?
Finding: There is a high incidence of malnutrition in pediatric surgical patients. Stunting increases the risks of postoperative complications and extended hospital stays, while underweight status contributes to extended hospital stays.
Meaning: Preoperative nutritional assessments are crucial to improving postoperative outcomes. Anemia increases the risk of postoperative complications and should be corrected preoperatively.
Allergy
Cohort profile: National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008)   (30 times)
Ju Hee Kim, Jung Eun Lee, So Min Shim, Eun Kyo Ha, Dong Keon Yon, Ok Hyang Kim, Ji Hyeon Baek, Hyun Yong Koh, Kyu Young Chae, Seung Won Lee, Man Yong Han
Clin Exp Pediatr. 2021;64(9):480-488.   Published online January 5, 2021
This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data.
Emergency Medicine
Comparison of clinical features and laboratory findings of coronavirus disease 2019 and influenza A and B infections in children: a single-center study   (30 times)
Meraj Siddiqui, Ayşe Gültekingil, Oğuz Bakırcı, Nihal Uslu, Esra Baskın
Clin Exp Pediatr. 2021;64(7):364-369.   Published online May 18, 2021
Question: What are the differences between coronavirus disease 2019 (COVID-19) and influenza infections in children?
Finding: Pediatric COVID-19 patients predominantly exhibited respiratory and/or gastrointestinal symptoms, neurological manifestations, olfactory/gustatory dysfunction, elevated monocytes, mildly elevated C-reactive protein, and unilateral or diffuse abnormalities on chest x-ray. Patients with underlying medical conditions had higher intensive care unit admission rates and should be followed closely.
Meaning: The clinical presentations of pediatric COVID-19 patients varied from asymptomatic/mild to severe.
Review Article
Neonatology (Perinatology)
Growth patterns of preterm infants in Korea   (30 times)
Joohee Lim, So Jin Yoon, Soon Min Lee
Clin Exp Pediatr. 2022;65(1):1-9.   Published online July 8, 2021
∙ The growth of preterm infants is a main focus of neonatology.
∙ Preterm infants in Korea, especially those with a very low birth weight, achieve retarded growth.
∙ Careful growth monitoring and early intervention will contribute to better development outcomes and quality of life for preterm infants and improve public health.
Editorial
Other
Three-dimensional printing technolgy in orthopedic oncology   (30 times)
Yongsung Kim
Clin Exp Pediatr. 2022;65(10):496-497.   Published online May 11, 2022
Orthopedic oncology is one of the most active fields in applying 3-dimensional printing technology from preoperative planning to intraoperative procedures such as accurate resection of tumors and reconstruction of huge bone defects.
Letters to the Editor
Gastroenterology
Functional gastrointestinal disorders and smartphone use in adolescents   (29 times)
Mauro Cinquetti, Marco Biasin, Marco Ventimiglia, Linda Balanzoni, Denise Signorelli, Angelo Pietrobelli
Clin Exp Pediatr. 2021;64(9):494-496.   Published online November 9, 2020
Question: Are functional gastrointestinal disorders (FGIDs) common in Italy? If so, what are the associated risk factors?
Finding: In this cross-sectional study of 1,594 adolescents, the prevalence of FGIDs was 30.9% and was mainly associated with smartphone addiction.
Meaning: Smartphone use and dietary habits should be monitored in children with FGIDs.
Editorial
Infection
Catheter care bundle and feedback to prevent central line-associated bloodstream infections in pediatric patients   (29 times)
Hye-Kyung Cho
Clin Exp Pediatr. 2021;64(3):119-120.   Published online December 8, 2020
• Intravascular catheter-related infection is an important cause of morbidity and mortality in children, and care bundles are effective and cost-saving in pediatric and neonatal patients.
• Providing regular feedbacks to critical care practitioners is helpful to maintain compliance to care bundle.
• Establishing a bundle policy (insertion and maintenance), monitoring compliance, and providing regular feedbacks are necessary for prevention of central line-associated bloodstream infections in pediatric patients.
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