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"Most downloaded" Articles are from the articles published in 2024 during the last six months.

Original Article
Neonatology (Perinatology)
Short-term outcomes of oropharyngeal administration of colostrum in preterm neonates: a double-blind placebocontrolled randomized trial   (22 times)
Ameneh Lamsehchi, Maryam Shokouhi Solgi, Mohammad Kazem Sabzehei, Behnaz Basiri, Elahe Talebi Ghane, Kiana Kimiaei Asadi, Sina Azadnajafabad
Clin Exp Pediatr. 2025;68(1):73-79.   Published online October 31, 2024
Question: What are the short-term outcomes of oropharyngeal administration of colostrum (OAC) in preterm neonates?
Finding: This study demonstrated the significantly lower rates of necrotizing enterocolitis, clinically suspected sepsis, shorter hospital stay, period to full enteral feeding, and antibiotic therapy period in the OAC group.
Meaning: This trial may further expand the clinical application of OAC in premature infants to reduce their length of hospital stay and complications.
Gastroenterology
Fecal microbiome profiles in infants with biliary atresia versus nonbiliary atresia cholestasis: a pilot study   (22 times)
Nur Azizah, Fadilah Fadilah, Silvia Werdhy Lestari, Muzal Kadim, Fithriyah Sjatha, Hanifah Oswari
Clin Exp Pediatr. 2025;68(11):932-943.   Published online August 20, 2025
Question: How does the gut microbiota profile of infants with biliary atresia (BA) differ from that of infants with non-BA cholestasis and healthy infants in the Indonesian population?
Finding: The unique fecal microbiome composition of the BA group differed significantly from that of the other 2 groups.
Meaning: There is an urgent need to improve dysbiosis in BA and non-BA cholestasis to prevent worsening liver injury in cholestasis.
Letter to the Editor
Gastroenterology
Pediatric abdominal ultrasound training program for pediatricians   (21 times)
Soon Chul Kim
Clin Exp Pediatr. 2024;67(9):474-476.   Published online August 20, 2024
Editorial
Hematology
Absolute versus functional iron deficiency   (21 times)
Hye Lim Jung
Clin Exp Pediatr. 2025;68(2):138-140.   Published online November 13, 2024
· Iron deficiency (ID), the most common cause of anemia, can be classified into absolute and functional types. Absolute ID is a state of low total body iron, while functional ID is a state of imbalance between iron demand and iron availability due to inflammation and/or infection.
· ID is diagnosed by serum ferritin and transferrin saturation levels.
Original Article
Nephrology (Genitourinary)
C3 glomerulopathy in children: experience at a resource-limited center   (21 times)
Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan
Clin Exp Pediatr. 2025;68(4):311-318.   Published online November 28, 2024
Question: What are the clinicopathological features and outcomes of pediatric C3 glomerulopathy (C3G) in resource-limited settings?
Finding: Children with C3G in resource-limited settings have significant morbidities, and most experience kidney sequelae despite treatment. Electron microscopy was performed in only 50% of our patients, while none received complement assays or genetic testing.
Meaning: Pediatric C3G presentation, management, and kidney outcomes vary. Its thorough evaluation and management are challenging in resource-limited settings.
Cardiology
Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea   (21 times)
Soo In Jeong, GI Beom Kim, Sung Hye Kim, Jae Yoon Na, Hong Ju Shin, Sin Weon Yun, Lucy Youngmin Eun, Sang Yun Lee, Chang-Ha Lee, Kwang Ho Choi, Seul Gi Cha, Mi Young Han
Clin Exp Pediatr. 2025;68(9):732-741.   Published online August 6, 2025
Question: What are the key challenges affecting pediatric cardiologists and cardiac surgeons in Korea?
Finding: Excessive workloads, low procedural volumes, and legal risks contribute to high burnout. Regional disparities limit skill maintenance and threaten workforce sustainability.
Meaning: Targeted policies ensuring fair workloads, legal protections, and regional support are essential to stabilizing the pediatric cardiac workforce and maintaining high-quality care.
Pulmonology
Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?   (21 times)
Rungrat Sukharom, Prakarn Tovichien, Kanokporn Udomittipong, Pinyapach Tiamduangtawan, Wattanachai Chotinaiwattarakul
Clin Exp Pediatr. 2025;68(1):80-90.   Published online November 6, 2024
Question: How Common is obstructive sleep apnea (OSA) in obese children? OSA is common in obese children, even without habitual snoring.
Finding: Among the subjects, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, 59.8% had desaturation, 20.5% had sleep-related hypoventilation, and 5.0% had obesity hypoventilation syndrome. Body mass index (BMI) and neck and waist circumferences were significantly associated with severe OSA.
Meaning: We recommend screening obese children (BMI > 29.2 kg/m2) for OSA.
Editorial
Neurology
Network-based biomarkers in pediatric drug-resistant epilepsy   (21 times)
Joseph Lim, Jaeso Cho, Hunmin Kim
Clin Exp Pediatr. 2026;69(8):636-638.   Published online July 24, 2026
Conventional preoperative evaluation in pediatric drug-resistant epilepsy relies on clinical surrogates that quantify seizure exposure but not its impact on brain networks. A newly developed diffusion-weighted imaging connectome biomarker, anchored to intracranial electroencephalography-confirmed seizure onset zones and resolved across 6 neurocognitive domains, addresses this gap. This individualized approach classifies cognitive impairment with high accuracy and may offer a more precise, clinically interpretable tool to inform surgical timing.
Original Article
Infection
Clinical characteristics and associated factors of pediatric acute necrotizing encephalopathy: a retrospective study   (20 times)
Huiling Zhang, Yilong Wang, Qianyun Ding, Xuekun Li, Sheng Ye
Clin Exp Pediatr. 2025;68(2):153-162.   Published online November 11, 2024
· The mortality rate of acute necrotizing encephalopathy was high.
· Laboratory tests revealed that the fatal group had higher creatinine, lactate, activated partial thromboplastin time, thrombin time, interleukin (IL)-6, IL-10, creatine kinase, and D-dimer than survivors.
· The fatal group displayed lower Glasgow Coma Scale scores and arterial pH.
Neurology
Patient-independent automated pediatric seizure monitoring based on expert-labeled electrographic ictal data as core reference knowledge   (20 times)
Yoon Gi Chung, Jaeso Cho, Anna Cho, Hunmin Kim, Byung Chan Lim
Clin Exp Pediatr. 2026;69(8):665-675.   Published online July 14, 2026
Question: Can deep learning models trained on expert-verified electroencephalography segments reliably detect seizures and be applied to single-channel wearable monitoring?
Finding: This technique demonstrated 80.1%–100% sensitivity and low false-alarm rates. On 1,604 expert-labeled segments, the model outperformed previous studies in terms of latency and accuracy across unseen datasets.
Meaning: Expert-labeled data are essential for achieving universal seizure detection. This channel-specific approach enabled efficient and continuous monitoring using wearable devices.
Critical Care Medicine
Cytokine profile of Post–cardiopulmonary bypass in children   (19 times)
Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surasombatpattana, Pharsai prasertsan
Clin Exp Pediatr. 2025;68(12):1015-1022.   Published online September 19, 2025
Question: Can cytokine levels predict low cardiac output syndrome (LCOS) in children post–cardiopulmonary bypass?
Finding: Elevated interleukin (IL)-6, IL-8, and tumor necrosis factor-α levels were associated with LCOS, with an increase in IL-8 of >56 pg/mL from baseline to immediately postoperative being the strongest predictor.
Meaning: Monitoring immediately postoperative IL-8 levels may help identify pediatric patients at risk of LCOS, enabling timely interventions to improve outcomes.
Editorial
Endocrinology
Rickets prevalence and treatment outcome: real-world data from Taiwan   (19 times)
Young Suk Shim
Clin Exp Pediatr. 2025;68(11):868-870.   Published online October 23, 2025
Rickets should be recognized as a significant public health concern during infancy and childhood. Recent studies from Taiwan have demonstrated a steady increase in the prevalence of nutritional rickets, and a similar trend is likely to emerge in Korea. Therefore, comprehensive clinical evaluation and appropriate biochemical assessment are essential to prevent long-term skeletal and systemic complications. Prompt diagnosis and timely initiation of appropriate treatment are crucial.
Erratum: Authour correciton
Author correction: Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial   (19 times)
Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium
Clin Exp Pediatr. 2026;69(5):455-455.   Published online April 28, 2026
Review Article
Endocrinology
Linking pediatric obesity to youth-onset type 2 diabetes: integrated longitudinal and cross-sectional evidence from population-based studies worldwide   (19 times)
Ashraf T. Soliman, Fawzia Alyafei, Nada Alaaraj, Noor Hamed, Shayma Mohamed, Ahmed Elawwa
Clin Exp Pediatr. 2026;69(8):622-635.   Published online July 20, 2026
Pediatric obesity and youth-onset type 2 diabetes have increased simultaneously across 6 continents over the last 25 years. Approximately 75% of affected youths are obese at diagnosis, beta-cell declines occur rapidly, and microvascular complications occur early. Glucagon-like peptide-1 receptor agonists and bariatric surgery achieve meaningful weight loss and glycemic improvement; however, the primary prevention of childhood obesity remains the most powerful strategy for arresting this epidemic.
Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis   (18 times)
Maya L. Nasser, Joseph Nasr, Reem B. Zalloum, Nathanael Q.E. Yap, Natalie E. Bourdakos, Shahid Miangul, Tara A. Betts, Hayato Nakanishi, Christian A. Than, Serge Jabbour
Clin Exp Pediatr. 2024;67(10):486-497.   Published online June 27, 2024
· The safety and efficacy of the two-bag versus one-bag system for treating patients with diabetic ketoacidosis (DKA) < 21 years remains unestablished.
· Our meta-analysis demonstrated similar safety outcomes but sooner DKA resolution and shorter mean response time for intravenous fluid changes for the two-bag system.
· This preliminary evidence suggests that the two-bag system has some advantages in efficacy, but further studies are needed to evaluate their extent.
Impact of hematopoietic stem cell transplantation on growth outcomes in mucopolysaccharidosis: a systematic review   (18 times)
Farzaneh Abbasi, Asal Khalili Dehkordi, Reihaneh Mohsenipour
Clin Exp Pediatr. 2025;68(6):417-427.   Published online March 11, 2025
Hematopoietic stem cell transplantation (HSCT) enhances the growth outcomes of pediatric patients with mucopolysaccharidosis, with early intervention leading to improved height, weight, and body mass index. However, achieving a standard adult height remains uncommon among these patients, even in cases of early HSCT. Growth hormone therapy provides short-term benefits but does not address long-term height deficits. Pubertal development is generally normal; however, precocious puberty and pubertal arrest may occur.
Original Article
Hematology
Hematopoietic stem cell transplantation in pediatric patients with type VI mucopolysaccharidosis   (18 times)
Vedat Uygun, Koray Yalçın, Hayriye Daloğlu, Seda Öztürkmen, Suna Çelen, Suleimen Zhumatayev, Gülsün Karasu, Akif Yeşilipek
Clin Exp Pediatr. 2025;68(8):601-607.   Published online March 11, 2025
Question: Could hematopoietic stem cell transplantation (HSCT) be an alternative to enzyme replacement therapy (ERT) for type VI mucopolysaccharidosis (MPS VI)?
Finding: HSCT is generally not offered due to reports of high toxicity and mortality. However, we detected fewer complications and graft-versus-host disease cases and no deaths with HSCT.
Meaning: HSCT is both less expensive than ERT and permanent; thus, it should be considered an alternative treatment for MPS VI.
Other
Impact of thyroid hormones and serum endothelin levels on pediatric asthma control: a case-control study of an Indian population   (18 times)
Murugaiyan Sathishbabu, Sathiya Ramasamy, Niranjjan Ramachandran, Soundararajan Palanisamy, Arulvijayavani Subramaniam
Clin Exp Pediatr. 2025;68(10):831-837.   Published online September 22, 2025
Question: What are the roles of thyroid hormones and endothelin in South Indian children with asthma?
Finding: Thyroid hormone and endothelin levels were significantly elevated in South Indian children with asthma; poorly controlled cases exhibited the highest levels. Elevated thyroid-stimulating hormone and endothelin levels were correlated with asthma severity.
Meaning: Serum endothelin is a potential surrogate marker for asthma severity that could aid the assessment and management of childhood asthma.
Infection
Association between vitamin D polymorphisms and binding protein and COVID-19 risk and severity in children   (18 times)
Victoria Giatraki, Helen Dimitriou, Georgia Martimianaki, Christos Tsatsanis, Emmanouil Galanakis, Chrysoula Perdikogianni
Clin Exp Pediatr. 2025;68(12):998-1006.   Published online October 22, 2025
Question: Addressing crucial genetic variants within the vitamin D pathway and coronavirus disease 2019 (COVID-19) susceptibility, the vitamin D receptor, vitamin D binding protein, and CYP27B1-1260 polmorphisms might be associated with COVID-19 occurrence and severity in children.
Finding: The FokI FF genotype might be an independent risk factor for COVID-19 severity in childhood.
Meaning: This research may further elucidate genetic susceptibility to multisystem viral infections and establish genetic markers for severe clinical outcomes.
Neonatology (Perinatology)
Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial   (17 times)
Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi
Clin Exp Pediatr. 2024;67(5):249-256.   Published online March 26, 2024
Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia?
Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants.
Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay.
Developmental and Behavioral Medicine
Neonatal risk factors associated with autism spectrum disorders: an umbrella review   (17 times)
Amir Mohammad Salehi, Erfan Ayubi, Salman Khazaei, Ensiyeh Jenabi, Saeid Bashirian, Zohreh Salimi
Clin Exp Pediatr. 2024;67(9):459-464.   Published online July 19, 2024
Question: What are the neonatal risk factors for autism spectrum disorder (ASD)?
Findings: Significant effect sizes were observed for congenital heart disease (odds ratio [OR], 1.35), macrosomia (OR, 1.11), low birth weight (OR, 1.63), very low birth weight (OR, 2.25), small for gestational age (OR, 1.17), jaundice (OR, 1.74), male sex (OR, 1.47), and Apgar score (OR, 1.40).
Meaning: These factors were identified as risk factors for ASD.
Review Article
Neurology
Cerebral organoid research for pediatric patients with neurological disorders   (17 times)
Jin Eun, Jung Eun Lee, Seung Ho Yang
Clin Exp Pediatr. 2025;68(4):269-277.   Published online November 28, 2024
Cerebral organoids obtained from human induced pluripotent stem cells are transforming the study of pediatric neurological diseases by providing more accurate models of human brain development and pathology. These advancements have improved pathology modeling and the potential for novel therapeutic approaches despite existing challenges such as reproducibility and vascularization.
Original Article
Neonatology (Perinatology)
Incidence of neural tube defects in tertiary care university hospital in Bangladesh   (17 times)
Ismat Jahan, Arif Hossain, Shah Nizam Uddin Shaon, Sadeka Choudhury Moni, Mohammad Kamrul Hassan Shabuj, Sanjoy Kumer Dey, Mohammad Abdul Mannan, Mohammod Shahidullah
Clin Exp Pediatr. 2025;68(7):530-538.   Published online April 1, 2025
Question: What is the burden of neural tube defects (NTDs) in a tertiary care neonatal intensive care unit in Bangladesh?
Finding: The overall incidence of NTD was 6.4 (range, 4.59–11.2) per 1,000 live births, and the meningomyelocele complex was the most frequent location.
Meaning: The high incidence of NTD found in a leading tertiary care multidisciplinary referral hospital in Bangladesh may not reflect that of the wider population.
Perspective
General Pediatrics
Navigating the complex behavioral landscape of children in foster care and adopted families   (17 times)
Anisha Choi, Sandhya J. Kadam
Clin Exp Pediatr. 2025;68(8):620-623.   Published online May 12, 2025
Original Article
Pulmonology
Oligohydramnios affects pulmonary functional/structural abnormalities in school-aged children with bronchopulmonary dysplasia   (16 times)
Jeong Eun Shin, Soon Min Lee, Mi-Jung Lee, Jungho Han, Joohee Lim, Haerin Jang, Ho Seon Eun, Min Soo Park, Soo Yeon Kim, Myung Hyun Sohn, Ji Ye Jung, Kyung Won Kim
Clin Exp Pediatr. 2024;67(5):257-266.   Published online April 16, 2024
Question: Is bronchopulmonary dysplasia (BPD) associated with functional/structural abnormalities later in life?
Finding: School-aged children with severe BPD had abnormalities on pulmonary function tests and lung computed tomography despite no subjective respiratory symptoms; however, only prenatal oligohydramnios and prolonged ventilator use were associated with abnormal lung function.
Meaning: Long-term monitoring of preterm infants’ lung health is essential, especially for those with prenatal oligohydramnios or prolonged ventilator use.
Other
Virtual, augmented, and mixed reality: potential clinical and training applications in pediatrics   (16 times)
Suyoung Yoo, Meong Hi Son
Clin Exp Pediatr. 2024;67(2):92-103.   Published online May 24, 2023
· Review of articles that investigated the applications of virtual, augmented, or mixed reality in pediatric clinical settings and in the training of pediatric medical professionals was conducted.
· A total of 89 studies were retrieved, with 36 randomized controlled trials.
· In most studies, intervention using the novel technology was at least as effective or more effective than the traditional method.
· Use of virtual, augmented, and mixed reality has potential in pediatrics.
Correspondence
Infection
A commentary on "COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus"   (16 times)
Hinpetch Daungsupawong, Viroj Wiwanitkit
Clin Exp Pediatr. 2025;68(8):624-625.   Published online April 16, 2025
Original Article
Pulmonology
Association of macrophage migration-inhibitory factor gene and growth differentiation factor 15 gene polymorphisms and their circulating levels with respiratory distress syndrome among preterm neonates   (16 times)
Ali Helmi Bakri, Mohammed H. Hassan, Khaled Abdalla Abd-Elbaseer, Mahmoud Abo-Alhassan Sayed, Ahmed Alamir Mahmoud Abdallah, Eman Ahmed Abd-Elmawgood
Clin Exp Pediatr. 2025;68(9):680-689.   Published online April 1, 2025
Question: Do macrophage migration-inhibitory factor (MIF) and growth differentiation factor-15 (GDF-15) levels and their gene polymorphisms affect RDS among preterm babies?
Finding: Significantly higher serum MIF and GDF-15 levels were observed in patients with severe respiratory distress syndrome (RDS). The mutant G- and C-alleles of GDF-15 rs4808793 C>G single nucleotide polymorphism (SNP) and MIF rs755622 G>C SNP were present at significantly higher frequencies in preterm neonates with RDS.
Meaning: MIF and GDF-15 play a significant role in neonatal RDS and its severity.
Cardiology
Effect of face mask on pulmonary artery pressure during echocardiography in children and adolescents   (15 times)
Alireza Ahmadi, Mohammad Reza Sabri, Zohreh Sadat Navabi
Clin Exp Pediatr. 2024;67(3):161-167.   Published online January 23, 2024
Question: Can face masks alter pulmonary pressure in children and adolescents with and without congenital heart disease?
Findings: Mask removal during echocardiography (ECHO) reduced pulmonary pressure.
Meaning: These findings suggest that face masks should be removed during ECHO in children and adolescents.
Nutrition
Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach   (15 times)
Ratu Ayu Dewi Sartika, Fadila Wirawan, Wawan Gunawan, Primasti Nuryandari Putri, Nurul Husna Mohd Shukri
Clin Exp Pediatr. 2024;67(7):358-367.   Published online June 21, 2024
Question: Does paternal support affect exclusive breastfeeding failure?
Finding: Exclusive breastfeeding failure by 3 months was affected by paternal support.
Meaning: Fathers should be included in breastfeeding education and antenatal care.


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