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"Most downloaded" Articles are from the articles published in 2020 during the last six months.

Review Article
Nutrition
Changes in health status of North Korean children and emerging health challenges of North Korean refugee children   (29 times)
Seong-Woo Choi
Clin Exp Pediatr. 2021;64(11):552-558.   Published online May 17, 2021
· Among North Korean refugee (NKR) children under 5 years, 61% and 9.3% were underweight in 1998 and 2017, respectively.
· The immunization rate of NKR children exceeded 90% since 2006.
· For NKR children, protein-energy malnutrition was the #1 cause of death in 2009 versus #17 in 2019.
· In 2020, stunting affected 5.4% and 0.9% and obesity affected 10.7% and 2.7% of NKR versus South Korean children, respectively.
Hematology
Genetic classification and confirmation of inherited platelet disorders: current status in Korea   (28 times)
Ye Jee Shim
Clin Exp Pediatr. 2020;63(3):79-87.   Published online February 6, 2020
Inherited platelet disorders (IPDs), which manifest as primary hemostasis defects, often underlie abnormal bleeding and a family history of thrombocytopenia, bone marrow failure, hematologic malignancies, undefined mucocutaneous bleeding disorder, or congenital bony defects. Wide heterogeneity in IPD types with regard to the presence or absence of thrombocytopenia, platelet dysfunction, bone marrow failure, and dysmegakaryopoiesis is observed in patients. The individual...
Infection
Epidemiology and clinical features of coronavirus disease 2019 in children   (28 times)
Soo-Han Choi, Han Wool Kim, Ji-Man Kang, Dong Hyun Kim, Eun Young Cho
Clin Exp Pediatr. 2020;63(4):125-132.   Published online April 6, 2020
Coronavirus disease-2019 (COVID-19), which started in Wuhan, China, in December 2019 and declared a worldwide pandemic on March 11, 2020, is a novel infectious disease that causes respiratory illness and death. Pediatric COVID-19 accounts for a small percentage of patients and is often milder than that in adults; however, it can progress to severe disease in some cases. Even neonates...
Editorial
General Pediatrics
Why should we be concerned about early menarche?   (28 times)
Hae Sang Lee
Clin Exp Pediatr. 2021;64(1):26-27.   Published online July 13, 2020
· Early menarche is associated with several health problems in later life.
· Early menarche can be caused by environmental factors such as increased subcutaneous fat, a high body mass index, and sugar-sweetened beverages as well as genetic factors.
· Health education can prevent early menarche by aiming to reduce the consumption of fructose, high concentrations of which are present in sugar-sweetened beverages.
Original Article
Cardiology
Vasovagal syncope with mild versus moderate autonomic dysfunction: a 13-year single-center experience   (28 times)
Han Eoul Lee, Dong Won Lee
Clin Exp Pediatr. 2022;65(1):47-52.   Published online June 1, 2021
Question: It is well known that autonomic dysfunction contributes to vasovagal syncope (VVS). Does the degree of autonomic dysfunction contribute to clinical manifestations, diagnostic methods, treatment, and prognosis?
Finding: The clinical manifestations, diagnostic methods, treatment, and prognosis differ between patients with mild and moderate degrees of autonomic dysfunction.
Meaning: VVS is caused by autonomic dysfunction, but autonomic dysfunction severity need not be classified.
Other
Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital   (28 times)
Muruganantham Balagurunathan, Thrilok Natarajan, Jothilakshmi Karthikeyan, Venkateshwaran Palanisamy
Clin Exp Pediatr. 2021;64(10):531-537.   Published online August 4, 2021
Question: What are the clinical spectrum, course, and short-term outcomes of multisystem inflammatory syndrome in children (MIS-C)?
Finding: MIS-C can have variable clinical manifestations. Fever is most common, followed by gastrointestinal and cardiovascular symptoms. Early identification and appropriate management lead to favorable outcomes.
Meaning: MIS-C can present in a myriad of ways and severities. High suspicion is necessary to ensure its early identification and appropriate management and favorable patient outcomes.
Letter to the Editor
Other
Changes in air pollution and childhood respiratory viral infections in Korea post-COVID-19 outbreak   (28 times)
Hyung Kyu Park, Jung Yeon Shim
Clin Exp Pediatr. 2022;65(4):211-213.   Published online February 17, 2022
Editorial
Endocrinology
Is type 1 diabetes related to coronavirus disease 2019 in children?   (28 times)
Minsun Kim
Clin Exp Pediatr. 2022;65(5):252-253.   Published online March 29, 2022
· Evidence shows that patients with type 1 diabetes have been severely affected by coronavirus disease 2019 (COVID-19) in various ways.
· Although there is no reliable evidence that COVID-19 worsens or induces diabetes, it can impair β-cell insulin secretion and glucose control by inducing inflammation and cytokine production.
· A study is needed of the short- and long-term relationship between diabetes and COVID-19 in the Korean pediatric population.
Original Article
Nephrology (Genitourinary)
Urinary neutrophil gelatinase-associated lipocalin: a marker of urinary tract infection among febrile children   (27 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.
Review Article
Neonatology (Perinatology)
Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up   (27 times)
Yumi Kono; on behalf of the Neonatal Research Network of Japan
Clin Exp Pediatr. 2021;64(7):313-321.   Published online November 9, 2020
· Very low birth weight infants remain at high risk of developing neurodevelopmental impairments in early childhood.
· It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.
· All possible strategies should be employed to maintain good compliance after neonatal intensive care unit discharge.
Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019   (26 times)
Jang Hoon Lee, YoungAh Youn, Yun Sil Chang; Korean Neonatal Network
Clin Exp Pediatr. 2020;63(8):284-290.   Published online February 5, 2020
The Korean Neonatal Network (KNN) has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. The survival rate of all VLBWIs was 86% in Korea. The overall prevalence of cerebral palsy was 6.2%–6.6%. Bilateral blindness and hearing loss were reported in 0.2%–0.3%, 0.8%–1.9%, respectively. The KNN has published annual reports and papers for facilitating the improvement of VLBWIs outcome in Korea.
Clinical Note
Allergy
Recurrent urticaria caused by specific cat serum albumin IgE cross-reacting with pork serum albumin   (26 times)
Cheon Kim, Sung Won Kim, Yoon Ha Hwang
Clin Exp Pediatr. 2020;63(11):451-453.   Published online April 6, 2020
Question: What should be considered in children who complain of pork allergies?
Finding: History of raising a cat, the onset of symptoms after the ingestion of pork and specific IgE tests to pork, cat, milk, and Alpha-gal are needed.
Meaning: Pork cat syndrome could be the cause of pork allergies.
Original Article
Endocrinology
Zinc transporter 8 autoantibody in the diagnosis of type 1 diabetes in children   (26 times)
Nur Rochmah, Muhammad Faizi, Siti Wahyu Windarti
Clin Exp Pediatr. 2020;63(10):402-405.   Published online October 6, 2020
Question: Can zinc transporter 8 autoantibody (ZnT8A) be used for diagnosing type 1 diabetes (T1D)?
Finding: Twenty-two of 30 subjects with type 1 diabetes (73.3 %) were positive for ZnT8A compared to 5 of 18 controls (27.8%).
Meaning: ZnT8A has potential for clinical applications in the diagnosis of T1D.
Review Article
Immunology
Modern diagnostic capabilities of neonatal screening for primary immunodeficiencies in newborns   (26 times)
Evgenia Olegovna Khalturina, Natalia Dmitrievna Degtyareva, Anastasiia Vasi’evna Bairashevskaia, Alena Valerievna Mulenkova, Anna Vladimirovna Degtyareva
Clin Exp Pediatr. 2021;64(10):504-510.   Published online March 25, 2021
· Neonatal screening for primary immunodeficiency diseases (PIDs) enables early diagnosis and subsequent initiation of therapy.
· Excision of T-cell receptors and kappa-recombination excision circles are cheaper alternative PID screening methods.
· Sanger DNA sequencing remains the reference method for detecting PID; however, next-generation sequencing technology is increasingly used to diagnose it.
· Here we developed a graphical algorithm for diagnosing primary immunodeficiency syndrome based on modern methods of screening for primary immunodeficiencies in newborns.
Original Article
Endocrinology
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis   (26 times)
Azam Maleki, Saeid Bashirian, Ali Reza Soltanian, Ensiyeh Jenabi, Abdollah Farhadinasab
Clin Exp Pediatr. 2022;65(2):85-89.   Published online April 15, 2021
Question: Have polycystic ovary syndrome (PCOS) increased risk of having an offspring with attention-deficit/hyperactivity disorder (ADHD)?
Finding: Six articles (3 cohort and 3 case-control studies; 401,413 total ADHD cases) met the study criteria. Maternal PCOS was associated with an increased risk of ADHD in the offspring based on odds ratio (OR) and relative ratio (RR) (OR, 1.42; 95% confidence interval [CI], 1.27–1.57) and (RR, 1.43; 95% CI, 1.35–1.51), respectively.
Meaning: Our study showed that maternal PCOS is a risk factor for ADHD.
Editorial
Infection
Effects of nonpharmaceutical interventions for coronavirus disease 2019   (26 times)
Jae Hong Choi
Clin Exp Pediatr. 2022;65(5):250-251.   Published online March 22, 2022
∙ Nonpharmaceutical interventions (NPIs) have decreased the incidence of various infectious diseases, including coronavirus disease 2019 (COVID-19).
∙ During the 2-year COVID-19 pandemic, NPIs changed patients’ daily lives, and the impact on mental health was notable.
∙ The effects of NPIs were evaluated in detail, considering both infections and mental health.
Cardiology
Can the accurate epidemiological study help to search the etiology of Kawasaki disease?   (25 times)
Ji Whan Han
Clin Exp Pediatr. 2020;63(3):96-97.   Published online August 7, 2019
Original Article
Other
Korean parents’ perceptions of the challenges and needs on school re-entry during or after childhood and adolescent cancer: a multi-institutional survey by Korean Society of Pediatric Hematology and Oncology   (25 times)
Jun Ah Lee, Jae Min Lee, Hyeon Jin Park, Meerim Park, Byung Kiu Park, Hee Young Ju, Ji Yoon Kim, Sang Kyu Park, Young Ho Lee, Ye Jee Shim, Heung Sik Kim, Kyung Duk Park, Yeon-Jung Lim, Hee Won Chueh, Ji Kyoung Park, Soon Ki Kim, Hyoung Soo Choi, Hyo Seop Ahn, Jeong Ok Hah, Hyoung Jin Kang, Hee Young Shin, Mee Jeong Lee
Clin Exp Pediatr. 2020;63(4):141-145.   Published online November 14, 2019
Question: What are the parental needs and challenges when their children return to school after cancer?
Finding: In addition to scholastic aptitude-oriented programs, emotional and psychosocial support is necessary for a successful return to school.
Meaning: Pediatric oncologists should actively engage in improving oncology practices to better integrate individualized school plans and educate peers and teachers to improve health literacy to make them understand the needs of children with cancer.
Review Article
General Pediatrics
Association between maternal smoking during pregnancy and risk of bone fractures in offspring: a systematic review and meta-analysis   (25 times)
Erfan Ayubi, Saeid Safiri, Kamyar Mansori
Clin Exp Pediatr. 2021;64(3):96-102.   Published online February 5, 2020
Question: What is the effect of maternal smoking during pregnancy (MSDP) on the risk of bone fractures in the offspring?
Finding: After the adjustment for misclassification, MSDP may be associated with a 27% increased risk of bone fracture in the offspring (pooled odds ratio, 1.27; 95% confidence interval, 1.00–1.62; I2=0%; P=0.537)
Meaning: Preventive measures and health education programs should be designed and implemented to encourage women to stop smoking, especially during.
Original Article
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   (25 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.
Editorial
Allergy
Dietary restriction misconceptions and food allergy education in children with atopic dermatitis   (25 times)
You Hoon Jeon
Clin Exp Pediatr. 2022;65(2):83-84.   Published online January 27, 2022
∙ Food intake strategies for preventing food allergies have undergone major changes over the past 20 years.
∙ In children with atopic dermatitis, indiscriminate food restrictions without diagnostic testing leads to nutritional imbalance and poor growth.
∙ When determining food restrictions for pediatric patients with atopic dermatitis, an accurate food allergy diagnosis must be preceded, and continuous parental education about food intake is required.
Correspondence and Reply
Psychiatric/Psychology
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis   (25 times)
Hadith Rastad, Mahnaz Seifi Alan
Clin Exp Pediatr. 2022;65(3):152-152.   Published online February 17, 2022
Original Article
Neonatology (Perinatology)
Perinatal outcome and possible vertical transmission of coronavirus disease 2019: experience from North India   (24 times)
Ritu Sharma, Shikha Seth, Rakhee Sharma, Sanju Yadav, Pinky Mishra, Sujaya Mukhopadhyay
Clin Exp Pediatr. 2021;64(5):239-246.   Published online February 16, 2021
Question: Is there any risk of vertical transmission of coronavirus disease 2019 (COVID-19), and what is its neonatal profile?
Finding: Biological samples for vertical transmission were negative in all deliveries; however, 2 neonates tested positive for nasopharyngeal COVID-19 reverse transcription-polymerase chain reaction. No significant neonatal morbidity was observed.
Meaning: COVID-19 does not increase adverse neonatal outcomes and shows a negligible risk of vertical transmission; however, horizontal transmission cannot be underestimated.
Review Article
Hematology
Thrombosis and severe acute respiratory syndrome coronavirus 2 vaccines: vaccine-induced immune thrombotic thrombocytopenia   (24 times)
Young Shil Park
Clin Exp Pediatr. 2021;64(8):400-405.   Published online June 30, 2021
· Thrombosis and thrombocytopenia occurring within 4–28 days after severe acute respiratory syndrome coronavirus 2 vaccination require attention.
· The terms vaccine-induced immune thrombotic thrombocytopenia (VITT) and thrombosis with thrombocytopenia syndrome (TTS) are used.
· VITT is pathogenetically similar to heparin-induced thrombocytopenia.
· VITT/TTS could be associated with the development of platelet-activating anti-platelet factor 4 antibodies.
· For suspected VITT/TTS, early treatment decisions (intravenous immunoglobulin, non-heparin anticoagulant, and avoidance of platelet transfusions) are important.
Original Article
Developmental and Behavioral Medicine
Effectiveness of obesity interventions among South Korean children and adolescents and importance of the type of intervention component: a meta-analysis   (24 times)
Siyoung Choe, Jaesin Sa, Jean-Philippe Chaput, Deokjin Kim
Clin Exp Pediatr. 2022;65(2):98-107.   Published online November 23, 2021
Question: What is the overall effect of obesity interventions among Korean children and what affects their effectiveness?
Finding: Interventions were strongly favored over controls. Interventions including at least one physical activity component were significantly better than those that did not. Sex, age, baseline weight category, intervention duration, and the number of intervention components were not significant.
Meaning: Future obesity interventions for Korean children must seek to include physical activity components.
Letter to the Editor
Neonatology (Perinatology)
Telemedicine as progressive treatment approach for neonatal jaundice due to the coronavirus disease 2019 pandemic   (24 times)
Sukanya Sudhir Joshi, Bithiah Roy Benroy, Isabell Nelson Lawrence, Thanuja Jayasri Suresh
Clin Exp Pediatr. 2022;65(5):269-271.   Published online February 7, 2022
Question: How can the management of neonatal jaundice (NJ) be enhanced through telemedicine?
Finding: Teleconsultations, drive-through testing, and the use of an application to assess neonatal jaundice at home are being successfully used, but they must be further researched before being implemented on a larger scale.
Meaning: Recent technology allows for the treatment of NJ at home with an application that helps reduce hospital burden.
Letters to the Editor
Gastroenterology
Functional gastrointestinal disorders and smartphone use in adolescents   (23 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.
Review Article
Allergy
Eosinophils and childhood asthma   (23 times)
Bong Seok Choi
Clin Exp Pediatr. 2021;64(2):60-67.   Published online January 6, 2021
•In allergic eosinophilic asthma, eosinophils act as important effector cells and antigen-presenting cells, while in nonallergic eosinophilic asthma, type 2 innate lymphoid cells play an important role in eosinophil activation.
•Sputum eosinophil counts can be helpful for evaluating allergic airway inflammation in asthma.
• Anti-interleukin-5 has broadened the scope of asthma treatment.
Original Article
Cardiology
Assessment of cardiac function in syncopal children without organic causes   (23 times)
Heoungjin Kim, Lucy Youngmin Eun
Clin Exp Pediatr. 2021;64(11):582-587.   Published online March 10, 2021
Question: Does a subtle deterioration in cardiac function affect the severity of syncope in patients without underlying disease?
Finding: For syncope patients with reasonable cardiac function but without underlying disease, tissue Doppler imaging (TDI) measurements helped reveal subtle differences in cardiac function with syncope and predicted the severity of syncope or a potential recurrent event.
Meaning: TDI measurements might be a useful indicator for predicting the severity of syncope.
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