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

Letter to the Editor
General Pediatrics
Skipping breakfast is associated with lifestyle habits among Japanese pupils   (19 times)
Jun Kohyama
Clin Exp Pediatr. 2021;64(8):433-435.   Published online November 4, 2020
Question: Breakfast is important; however, adolescents are increasingly skipping it.
Finding: Skipping breakfast is independently associated with sleepiness, physical inactivity, dinner irregularity, screen time on school days, poor academic performance, after-school activity, and decreased sleep duration before school day.
Meaning: Reducing screen time on school days, after-school activity, and irregular dinner habits might decrease breakfast skipping, resulting in decreased sleepiness and improved academic performance.
Editorial
Hematology
Time to pay attention to anemia in female adolescents   (19 times)
Jae Min Lee
Clin Exp Pediatr. 2021;64(2):78-79.   Published online February 1, 2021
Review Article
Infection
Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia   (19 times)
Hye-Kyung Cho
Clin Exp Pediatr. 2021;64(9):459-467.   Published online February 10, 2021
• To avoid unnecessary exposure to secondary antibiotics, it is needed to diagnose Mycoplasma pneumoniae (MP) pneumonia carefully, especially when unresponsiveness to macrolide is suspected.
• Serologic and molecular tests for MP infection and excluding respiratory infection caused by other pathogens might be considered.
• It is necessary to continuously monitor antibiotic susceptibility of MP, and efforts to lower antibiotic pressure are required.
Letter to the Editor
Allergy
Environmental and dietary factors to be checked for treatment of atopic dermatitis in rural children   (19 times)
Sanghwa Youm, Eunjoo Lee, Jeongmin Lee
Clin Exp Pediatr. 2021;64(12):661-663.   Published online October 1, 2021
Question: What are the distinctive features of rural children with atopic dermatitis?
Finding: Birch and dog dander were the second most sensitized aeroallergens (32.6%), followed by house dust mites. Doctors and guardians reported food allergy comorbidities differently (19.9% and 43.5%, respectively). Dietary restrictions without medical evaluation were observed in 39.7% of patients.
Meaning: Effects of pollen distribution and indirect animal exposure should be evaluated. Evidence-based dietary restrictions must be implemented.
Original Article
Neonatology (Perinatology)
Is fetal nuchal cord associated with autism spectrum disorder? A meta-analysis   (19 times)
Ensiyeh Jenabi, Maryam Ahmadi, Azam Maleki
Clin Exp Pediatr. 2022;65(3):131-135.   Published online September 24, 2021
Question: Is fetal nuchal cord a risk factor for autism spectrum disorder (ASD)?
Finding: Five articles (1 cohort, 4 case-control; total 3,088 children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (odds ratio, 1.11; 95% confidence interval, 0.66–1.57). There was homogeneity among studies that reported a risk of ASD (I2=0.0).
Meaning: Fetal nuchal cord is not a risk factor for ASD.
Review Article
General Pediatrics
A new perspective on cholesterol in pediatric health: association of vitamin D metabolism, respiratory diseases, and mental health problems   (19 times)
Jeana Hong
Clin Exp Pediatr. 2022;65(2):65-72.   Published online December 9, 2021
∙ Pediatric dyslipidemia is associated with several health problems besides cardiovascular diseases.
∙ There is a direct association between pediatric dyslipidemia and low serum vitamin D levels, asthma, and mental health problems regardless of body mass index.
∙ More large-scale nationally representative studies are needed to establish the appropriate cutoff points for the definition of dyslipidemia that is a prerequisite for further epidemiological studies in the Korean pediatric population.
Editorial
Infection
Importance of maintaining a high childhood vaccination rate and surveillance program against Japanese encephalitis in Korea   (19 times)
Su Eun Park
Clin Exp Pediatr. 2022;65(3):127-128.   Published online February 16, 2022
∙ Recent epidemiologic changes of Japanese encephalitis (JE) in Korea are area (rural to urban or suburban) and age shift (children to adult).
∙ Although the main factors contributing to recent epidemiologic changes of JE are not well identified, maintaining high vaccination rates of JE appear to be important in preventing of JE in all age groups.
∙ Continuous surveillance for epidemiology and seroprevalence should be carried out.
Correspondence and Reply
Neurobehavior
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis   (19 times)
Hadith Rastad, Mahnaz Seifi Alan
Clin Exp Pediatr. 2022;65(3):152-152.   Published online February 17, 2022
Editorial
Cardiology
Coronavirus disease 2019 and mRNA vaccines: what’s next – miRNA?   (19 times)
Joon Kee Lee, Heon-Seok Han
Clin Exp Pediatr. 2022;65(6):302-303.   Published online March 28, 2022
MicroRNAs (miRNAs) are small single-stranded noncoding RNA molecules that function in RNA silencing and the posttranscriptional regulation of gene expression. The potential role of miRNAs as biomarkers of myocarditis is promising, and miRNAs are expected to be utilized in various clinical fields in the future.
Neonatology (Perinatology)
Factors to consider before implementing telemedicine protocols to manage neonatal jaundice   (19 times)
Heui Seung Jo
Clin Exp Pediatr. 2022;65(8):403-404.   Published online April 12, 2022
In the rapidly changing environmental situation during the coronavirus disease 2019 outbreak, neonatal centers have developed telemedicine systems with extended coverage for neonatal monitoring and high-risk follow-up programs including neonatal hyperbilirubinemia. At this point, electronic health technology and noncontact medical system increase the effectiveness of rather than replacing the face-to-face visit and the opinions of experienced neonatologists.
Review Article
Genetics and Metabolism
Understanding the genetics of systemic lupus erythematosus using Bayesian statistics and gene network analysis   (18 times)
Seoung Wan Nam, Kwang Seob Lee, Jae Won Yang, Younhee Ko, Michael Eisenhut, Keum Hwa Lee, Jae Il Shin, Andreas Kronbichler
Clin Exp Pediatr. 2021;64(5):208-222.   Published online July 15, 2020
Bayesian false-discovery probability and false-positive report probability are the 2 major Bayesian methods used to evaluate noteworthiness of a genetic variant.
Application of stricter P value is needed to confirm statistical significance in meta-analyses.
Gene network analysis of noteworthy genetic variants shows a blueprint of the genetic background in complex diseases.
Original Article
Allergy
Sex-based differences in factors associated with bronchial hyperresponsiveness in adolescents with childhood asthma   (18 times)
Young Hwan Kim, Yoon Young Jang, Jieun Jeong, Hai Lee Chung
Clin Exp Pediatr. 2021;64(5):229-238.   Published online January 14, 2021
Question: What factors are associated with bronchial hyperresponsiveness (BHR) in adolescents with childhood asthma?
Finding: Age, mold sensitization, and increased eosinophil count were associated with BHR in boys versus a reduced forced expiratory volume in 1 second/forced vital capacity ratio in girls. Early mold sensitization was a risk factor for persistent BHR in boys only.
Meaning: Sex-specific differences were observed in the factors associated with BHR in adolescents.
Endocrinology
Correlation between total air pollutant emissions and incidence of type 1 diabetes in the Russian Federation   (18 times)
Hoon Sung Choi, Jin Taek Kim, Ji-Young Seo, Faina Linkov, Evgeniy Shubnikov, Hong Kyu Lee
Clin Exp Pediatr. 2021;64(10):525-530.   Published online January 18, 2021
Question: Is there a quantitative relationship between air pollutant emissions and the incidence of type 1 diabetes (T1D)?
Finding: The incidence of T1D in each region of the Russian Federation correlated with the total air pollutants emitted each year.
Meaning: These findings suggest that air pollution contributes to the development of T1D.
Editorial
Immunology
Importance of neonatal screening for primary immunodeficiencies   (18 times)
Jung Woo Rhim
Clin Exp Pediatr. 2021;64(10):519-520.   Published online May 4, 2021
· Early detection of asymptomatic infants with primary immunodeficiencies before the onset of infections enables effective treatment and intervention to prevent serious sequelae.
· T-cell receptor excision circles and kappa-deleting recombination excision circles have recently been used to detect T- or B-cell lymphopenia in neonates.
Allergy
Dietary restriction misconceptions and food allergy education in children with atopic dermatitis   (18 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.
Clinical considerations and practical issues of allergic diseases in COVID-19 era   (18 times)
Sungsu Jung
Clin Exp Pediatr. 2022;65(12):587-588.   Published online November 29, 2022
The risk of sudden acute respiratory syndrome coronavirus 2 infection and severe coronavirus disease 2019 (COVID-19) outcomes is not elevated in patients with the type 2 phenotype and well-controlled asthma. Inhaled corticosteroids, intranasal corticosteroids, and topical steroids can be safely used in COVID-19 patients. Biologics can be safely used by patients with allergic diseases without concern about antibody responses.
Original Article
Hematology
Changes in the prevalence of anemia in Korean adolescents, 1998–2018   (17 times)
Jun Young An, Yoo Rha Hong, Seom Gim Kong
Clin Exp Pediatr. 2021;64(2):86-92.   Published online November 16, 2020
Question: Over the past 21 years, has the prevalence of anemia decreased among Korean adolescents?
Finding: The prevalence of anemia in boys aged 10–18 years decreased from 3.0% to 0.5% over the study period, whereas that in girls did not change significantly over time (increased from 7.9% to 8.5%).
Meaning: The prevalence of anemia in female adolescents remains high, requiring attention and efforts to improve it.
Editorial
Infection
Should we prescribe carbapenem for treating febrile urinary tract infection caused by extended-spectrum β-lactamase-producing Enterobacteriaceae in children with vesicoureteral reflux?   (17 times)
Ji Young Park
Clin Exp Pediatr. 2021;64(6):284-285.   Published online January 5, 2021
Recent studies are focused on the noninferiority of noncarbapenem therapy for the treatment of extended-spectrum β-lactamases producing Enterobacteriaceae infections to reduce the utilization of carbapenem.
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   (17 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.
Editorial
Endocrinology
Clinical and diagnostic importance of dyslipidemia in children and adolescents during the coronavirus disease 2019 pandemic   (17 times)
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.
Neonatology (Perinatology)
Ideal timing for aggressive screening to detect developmental dysplasia of the hip in term and preterm infants   (17 times)
Won-Ho Hahn
Clin Exp Pediatr. 2022;65(7):346-347.   Published online March 14, 2022
The risk factors and pathogenesis of developmental dysplasia of the hip (DDH) are unclear. Moreover, no universal screening method can entirely eliminate the risk of DDH. However, its incidence is significant and its early detection is critical for improving patient prognosis. Although the ideal evaluation time and risk factors, especially for premature infants, are unclear, the necessity for DDH screening programs for term and preterm infants is emerging.
Endocrinology
Is type 1 diabetes related to coronavirus disease 2019 in children?   (17 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.
Review Article
Other
Epidemiology of pediatric fractures before versus during the coronavirus disease 2019 pandemic   (17 times)
Chi Hoon Oh, Siyeong Yoon, Kyung Rae Ko, Young Woo Kwon, Kyeong Mi Kim, Hyun Seo Park, Hogyeong Kang, Inseok Jang, Soonchul Lee
Clin Exp Pediatr. 2022;65(7):330-336.   Published online June 3, 2022
∙ The novel coronavirus disease 2019 (COVID-19) was first reported in December 2019 as a cluster outbreak in Wuhan, since then, national lockdowns have included school closures, stay-at-home orders.
∙ The characteristics of adolescent fractures were often related to physical activity such as sports-related injury.
∙ During the COVID-19 pandemic, both in the East and the West, the incidence of fractures in children and adolescents is showing a decreasing trend worldwide.
∙ Fractures in children and adolescents were significantly reduced in the proportion of relatively low-energy damage, and the incidence of fractures in adolescents with greater activity compared to children was reduced.
∙ If COVID-19 pandemic ends, normal academic and sports activities increase due to the easing of lockdown policies, the number of trauma patients related to increased activity may increase rapidly, and clinics should prepare for this change.
Editorial
Neurology
Psychogenic nonepileptic seizures; beyond differentiating from epileptic seizures   (16 times)
Sang Ook Nam
Clin Exp Pediatr. 2021;64(6):282-283.   Published online November 12, 2020
Allergy
Targeting eosinophils: another strategy for asthma treatment   (16 times)
Hye Mi Jee
Clin Exp Pediatr. 2021;64(5):223-224.   Published online March 5, 2021
Identifying phenotypes and endotypes of asthma patients is challenging, and eosinophilic phenotypes are generally characterized by severe or refractory asthma.
Biologicals targeting eosinophils are promising for the control of severe or refractory asthma symptoms.
To ensure proper treatment, increased understanding of the diverse phenotypes of high Th2 inflammation in pediatric asthma is needed.
Infection
Babies born to mothers positive for SARS-CoV-2 – Are they in danger?   (16 times)
Joon Kee Lee
Clin Exp Pediatr. 2021;64(6):280-281.   Published online May 4, 2021
Concerns have arisen in the coronavirus disease 2019 (COVID-19) pandemic upon pregnancy and postnatal care starting from reproductive decision-making. To the utmost knowledge, reproductive decisions should not be based primarily on health-related COVID-19 concerns, as the possibility of vertical transmission is negligible and the perinatal outcome is generally not poor compared to pregnancies without COVID-19, as long as infection control measures are well kept.
Original Article
Other
Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital   (16 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.
Editorial
Pulmonology
Influence of coronavirus disease 2019 pandemic on respiratory health in children   (16 times)
Hyo-Bin Kim
Clin Exp Pediatr. 2022;65(7):348-349.   Published online May 3, 2022
· Practicing hand hygiene, wearing a mask, maintaining social distancing, and other lockdown measures were implemented to reduce the spread of coronavirus disease 2019 (COVID-19), a worldwide disaster that started in 2019.
· The advent of the worldwide COVID-19 pandemic resulted in positive secondary effects, such as reduced respiratory viral infections in children and decreased degrees of air pollution.
Nutrition
Human milk oligosaccharides as immunonutrition key in early life   (16 times)
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.
Neurology
Recent trends in autism spectrum disorder research using text mining of PubMed: importance of early detection   (15 times)
Seung Soo Kim
Clin Exp Pediatr. 2021;64(7):339-340.   Published online November 9, 2020
Behavioral therapy, the most widely proven intervention for the core symptoms of autism spectrum disorder (ASD), is required for life for individuals with ASD. Parent involvement, early detection, and early therapy play important roles. We must organize the risk factors for ASD and develop a screening tool that can be easily applied in the clinical, daycare, or school setting.
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