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"Most viewed" Articles are from the articles published in 2022 during the last six month.

Letter to the Editor
Neonatology (Perinatology)
Association between feeding intolerance and intestinal dysbiosis in very premature infants   (56,701 times)
Putri Maharani Tristanita Marsubrin, Agus Firmansyah, Rinawati Rohsiswatmo, Zakiudin Munasir, Saptawati Bardosono, Safarina G. Malik, Yuditiya Purwosunu, Ina S. Timan, Tetty Yuniati, Maya Yulindhini
Clin Exp Pediatr. 2023;66(11):501-503.   Published online October 24, 2023
Original Article
Neonatology (Perinatology)
Oral administration of bone marrow-derived mesenchymal stem cells attenuates intestinal injury in necrotizing enterocolitis   (31,298 times)
Yeong Seok Lee, Yong Hoon Jun, Juyoung Lee
Clin Exp Pediatr. 2024;67(3):152-160.   Published online February 19, 2024
Question: What is the optimal dose of bone marrow-derived mesenchymal stem cells (BM-MSCs) for treating necrotizing enterocolitis (NEC), and is orally administered BM-MSC effective?
Findings: High (1×106 cells) or multiple BM-MSC doses showed similar effects as low (1×105 cells) doses of intraperitoneally administered BM-MSCs. Furthermore, orally administered BM-MSCs were as effective as intraperitoneally administered BM-MSCs.
Meaning: Orally administered low-dose BM-MSCs are a potential treatment for NEC.
Developmental and Behavioral Medicine
Impact of short and intensive art-based intervention on symptomatology and social interactions among children with autism spectrum disorder   (31,054 times)
Deldar Morad Abdulah, Bayar Mohammed Omar Abdulla, Pranee Liamputtong
Clin Exp Pediatr. 2023;66(10):447-454.   Published online September 14, 2023
Question: Does a short and intensive art-based intervention affect symptoms and social interactions among children with autism spectrum disorder (ASD)?
Finding: The short and intensive art-based intervention did not affect symptoms in children with ASD level 2 or 3, including social awareness, social cognition, social communication, social motivation, and autistic mannerisms.
Meaning: The short and intensive art-based intervention did not improve the symptoms of patients with ASD.
Editorial
Endocrinology
Nonalcoholic fatty liver disease in children and adolescents   (26,971 times)
Hae Sang Lee
Clin Exp Pediatr. 2024;67(2):90-91.   Published online January 24, 2024
· With the increase in childhood obesity, nonalcoholic fatty liver disease (NAFLD) has become a concern in recent years.
· NAFLD is strongly associated with insulin resistance.
· Lifestyle modifications are the mainstay treatment for NAFLD.
Original Article
Adolescence Medicine
Relationship between inflammatory biomarkers and insulin resistance in excess-weight Latin children   (23,037 times)
Mariano Nicolás Aleman, María Constanza Luciardi, Emilce Romina Albornoz, María Cristina Bazán, Adela Victoria Abregú
Clin Exp Pediatr. 2024;67(1):37-45.   Published online December 21, 2023
Question: What is the prevalence of insulin resistance (IR) in excess-weight Latin children, and can proinflammatory biomarkers predict it?
Finding: IR prevalence was elevated and tumor necrosis factor- α, interleukin-6, monocyte chemoattractant protein- 1, soluble CD40 ligand, and high-sensitivity C-reactive protein levels were increased in excess-weight Latin children. However, none predicted IR status.
Meaning: These inflammatory biomarkers were unable to predict IR status. Therefore, further investigations are necessary.
Review Article
Infection
Global varicella vaccination programs   (5,955 times)
Young Hwa Lee, Young June Choe, Jia Lee, Eunseong Kim, Jae Young Lee, Kwan Hong, Yoonsun Yoon, Yun-Kyung Kim
Clin Exp Pediatr. 2022;65(12):555-562.   Published online November 2, 2022
It is important to evaluate its effectiveness at the national level and to determine the varicella vaccine schedule based on the evidence generated through the studies.
Neurology
Update on benign convulsions with mild gastroenteritis   (3,847 times)
Yeong Seok Lee, Ga Hee Lee, Young Se Kwon
Clin Exp Pediatr. 2022;65(10):469-475.   Published online December 27, 2021
∙ The main pathogen for benign convulsions with mild gastroenteritis (CwG) was previously rotavirus; however, cases associated with norovirus are increasing.
∙ CwG is characterized by clustered generalized seizures. Electroencephalography and magnetic resonance imaging show transiently abnormal findings in the acute phase that eventually normalize with progression. Its prognosis is good, and long-term treatment is unnecessary.
∙ There are many reports on the pathophysiological mechanism of CwG, which remains unclear.
Pulmonology
Epidemiology and surveillance implications of community-acquired pneumonia in children   (3,664 times)
Eui Jeong Roh, Jung Yeon Shim, Eun Hee Chung
Clin Exp Pediatr. 2022;65(12):563-573.   Published online October 17, 2022
The identification of the causative pathogens of community-acquired pneumonia and appropriate treatment and prevention can reduce mortality and the socioeconomic burden by reducing the medical expenses. The world has been in the coronavirus disease 2019 pandemic since 2020, and there is always a risk of continuous emergence and epidemic of new respiratory infectious diseases. Therefore, it is important to sustain a monitoring system for respiratory infectious diseases including pneumonia.
Infection
Pathogenetic and etiologic considerations of febrile seizures   (3,472 times)
Ji Yoon Han, Seung Beom Han
Clin Exp Pediatr. 2023;66(2):46-53.   Published online January 13, 2023
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.
Neonatology (Perinatology)
Retinopathy of prematurity: a review of epidemiology and current treatment strategies   (3,339 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.
Neurology
Neonatal seizures: diagnostic updates based on new definition and classification   (2,987 times)
Eun-Hee Kim, Jeongmin Shin, Byoung Kook Lee
Clin Exp Pediatr. 2022;65(8):387-397.   Published online April 4, 2022
· Neonatal seizures are often electrographic-only seizures without clinical signs; therefore, the identification of electrical seizure activity on electroencephalography is the gold standard for diagnosis.
· Clinical signs of neonatal seizures are divided into motor or nonmotor seizures, and motor seizures are mostly focal or multifocal.
· Most neonatal seizures are caused by acute symptomatic etiologies, but in cases of intractable seizures, structural, genetic, or metabolic etiologies should be investigated.
Original Article
General Pediatrics
Global relationship between parent and child obesity: a systematic review and meta-analysis   (2,937 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
Cardiology
Implication of microRNA as a potential biomarker of myocarditis   (2,878 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.
Endocrinology
Genetic factors in precocious puberty   (2,708 times)
Young Suk Shim, Hae Sang Lee, Jin Soon Hwang
Clin Exp Pediatr. 2022;65(4):172-181.   Published online October 18, 2021
· Mutations in the kisspeptin (KISS1), kisspeptin receptor (KISS1R), makorin ring finger protein 3 (MKRN3), and delta-like homolog 1 (DLK1) genes are associated with idiopathic central precocious puberty (ICPP).
· A few genes related to pubertal onset have been implicated in ICPP.
· Epigenetic factors such as DNA methylation, histone posttranslational modifications, and noncoding ribonucleic acids may be related to ICPP
Other
Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy   (2,705 times)
Lisa Zhao, John P. Jones, Lauren G. Anderson, Zacharoula Konsoula, Cynthia D. Nevison, Kathryn J. Reissner, William Parker
Clin Exp Pediatr. 2024;67(3):126-139.   Published online June 14, 2023
Despite worldwide acceptance of acetaminophen (paracetamol) in pediatric medicine, careful examination reveals no valid objections to the conclusion that early exposure to acetaminophen causes neurodevelopmental injury in susceptible babies and children. Nevertheless, debate that early exposure to acetaminophen causes neurodevelopmental injury has centered around the prenatal period, evidence of which is relatively limited compared to that in the postnatal period, which is the time of greatest absolute and relative risk.
Original Article
Pulmonology
Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress   (2,679 times)
Kantara Saelim, Busawan Thirapaleka, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree
Clin Exp Pediatr. 2022;65(12):595-601.   Published online November 1, 2022
SpO2/FiO2 ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients.
Review Article
Nephrology (Genitourinary)
Kidney complications associated with COVID-19 infection and vaccination in children and adolescents: a brief review   (2,602 times)
Hee Sun Baek, Min Hyun Cho
Clin Exp Pediatr. 2023;66(10):424-431.   Published online June 28, 2023
Several observational studies have shown that acute kidney injury affects up to 46% of children and adolescents who develop severe postinflammatory responses, such as multisystem inflammatory syndrome in childhood, due to coronavirus disease 2019 (COVID-19). Although causality has not been established, some cases of glomerulopathy or nephrotic syndrome occurring after COVID-19 infection or vaccination have been reported. Therefore, kidney complications associated with these conditions in children and adolescents warrant attention.
Neurology
Pediatric syncope: pearls and pitfalls in history taking   (2,600 times)
Jung Sook Yeom, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(3):88-97.   Published online February 15, 2023
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.
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   (2,541 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.
Review Article
Nephrology (Genitourinary)
Blood pressure measurements and hypertension in infants, children, and adolescents: from the postmercury to mobile devices   (2,480 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.
Allergy
Diagnosis and management of asthma in infants and preschoolers   (2,443 times)
Hai Lee Chung
Clin Exp Pediatr. 2022;65(12):574-584.   Published online April 19, 2022
· Asthma in infants and preschoolers involves heterogeneous phenotypes.
· Asthma diagnosis is based on symptom patterns, therapeutic responses, and the presence of risk factors with careful consideration of differential diagnosis.
· Daily inhaled corticosteroid therapy remains the most effective strategy for managing persistent asthma symptoms irrespective of phenotype.
· Future research, including genetic and molecular studies, is needed to develop a clear definition of asthma and personalized therapeutic approaches.
Original Article
General Pediatrics
Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review   (2,442 times)
Preyal D. Jain, Akshatha Nayak, Shreekanth D. Karnad, Kaiorisa N. Doctor
Clin Exp Pediatr. 2022;65(3):142-149.   Published online June 11, 2021
Question: What are the primary motor and balance dysfunctions in children with Down syndrome?
Finding: These individuals have gross delays, altered balance, and inefficient compensatory mechanisms.
Meaning: Neuromuscular and musculoskeletal impairments due to the chromosomal abnormality lead to developmental delay. These children also exhibit poor balance with greater instability and inefficient compensatory mechanisms including altered center of pressure displacement and trunk stiffening that predisposes them to falls.
Editorial
Endocrinology
Bisphenol A leaching from polycarbonate baby bottles into baby food causes potential health issues   (2,384 times)
Ga Won Jeon
Clin Exp Pediatr. 2022;65(9):450-452.   Published online July 25, 2022
Can bisphenol A (BPA) leach out from polycarbonate baby bottles into baby food? BPA and other toxic materials can leach out from baby bottles and increase the risk of various health problems, including endocrine disturbances. Although the use of BPA in baby bottles has been banned, many developing countries still use it, which can cause health issues. Thus, public awareness of this issue is required.
Review Article
Gastroenterology
Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children   (2,365 times)
Yu Kyung Cho, Jin Lee, Chang Nyol Paik
Clin Exp Pediatr. 2023;66(9):377-383.   Published online August 21, 2023
· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition.
· SIBO is prevalent in children and adolescents with functional abdominal pain disorders.
· Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria.
· Breath tests are safe and noninvasive.
· Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics.
Neonatology (Perinatology)
Treatment of congenital cytomegalovirus infection   (2,364 times)
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(9):384-394.   Published online December 28, 2022
· Congenital cytomegalovirus (CMV) infection is among the most common causes of nongenetic sensorineural hearing loss.
· Congenital CMV is initially treated with intravenous ganciclovir for 2–6 weeks and switched to oral valganciclovir, or with oral valganciclovir for the entire 6-month period.
· Infants with congenital CMV require periodic monitoring of absolute neutrophil count, platelet count, and blood urea nitrogen, creatinine, liver function tests, audiological, ophthalmological, and developmental tests during antiviral medication.
Infection
Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment   (2,286 times)
Ki Wook Yun
Clin Exp Pediatr. 2024;67(2):80-89.   Published online June 14, 2023
· Most commonly confirmed causes of community-acquired pneumonia (CAP) in children are Mycoplasma pneumoniae (8%–40%) and respiratory syncytial virus (15%–20%).
· Pyogenic bacteria, most commonly Streptococcus pneumoniae (40%–50%) and Streptococcus pyogenes (10%–25%), are detected in 2%–5% of children hospitalized with CAP.
· CAP should be diagnosed conservatively according to clinical and radiological criteria.
· The etiology should be identified via appropriate test result interpretation.
Editorial
Allergy
Dietary restriction misconceptions and food allergy education in children with atopic dermatitis   (2,206 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.
Review Article
Endocrinology
Pediatric hypertension based on Japanese Society of Hypertension Guidelines (JSH 2019) with actual school blood pressure screening data in Japan   (2,193 times)
Toru Kikuchi
Clin Exp Pediatr. 2022;65(6):283-290.   Published online November 26, 2021
The prevalence of Japanese pediatric hypertension is 0.9% based on proper measurement protocols. Hypertensive children tend to be hypertensive adults. Pediatric essential hypertension is characterized by an absence of symptoms, obesity, a family history of hypertension, and a low birth weight. The most common causes of pediatric secondary hypertension are renal parenchymal and renovascular diseases. Important factors controlling pediatric hypertension include healthy lifestyle modifications and pharmacotherapy.
Gastroenterology
Factors influencing development of the infant microbiota: from prenatal period to early infancy   (2,149 times)
Sujin Jeong
Clin Exp Pediatr. 2022;65(9):439-447.   Published online December 23, 2021
∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial.
∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage.
∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life.
∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism.
Infection
Safety monitoring of COVID-19 vaccines: February 26, 2021, To June 4, 2022, Republic of Korea   (2,146 times)
Yeon-Kyeng Lee, Yunhyung Kwon, Yesul Heo, Eun Kyoung Kim, Seung Yun Kim, Hoon Cho, Seontae Kim, Mijeong Ko, Dosang Lim, Soon-Young Seo, Enhi Cho
Clin Exp Pediatr. 2023;66(10):415-423.   Published online June 13, 2023
· Enhanced safety monitoring system of coronavirus disease 2019 (COVID-19) vaccines were implemented to detect signals rapidly as part of the national COVID-19 vaccination program.
· As of June 4, 2023, reported adverse events after COVID-19 vaccination was 0.38% among 125,107,883 doses of COVID- 19 vaccines administered.
· Most reported adverse reactions after COVID-19 vaccinations have shown nonserious and mild intensity.
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