Clinical and Experimental Pediatrics

Review Article

Endocrinology

Endocrine comorbidities of pediatric obesity (1,528 times)

Jieun Lee, Jae Hyun Kim

Clin Exp Pediatr. 2021;64(12):619-627. Published online August 26, 2021

∙ Pediatric obesity can involve endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty.
∙ Prediabetes and type 2 diabetes in youth aged 10–19 years had a prevalence of 25.9% and 0.6% in 2013–2014, respectively.
∙ Dyslipidemia in Korean adolescents aged 10–18 years had a prevalence of 7.64% (total cholesterol ≥200 mg/dL), 6.09% (low-density lipoprotein cholesterol ≥130 mg/dL), 8.69% (triglyceride ≥150 mg/dL), and 12.52% (high-density lipoprotein cholesterol ≤40 mg/dL) in 2007–2018.
∙ Metabolic syndrome in Korean youth has a prevalence of 1.9%–14.7% in males and 1.7%–12.6% in females with wide variation in definitions.
∙ Appropriate comorbidity screening and management and/or specialist referral are necessary for obese children and adolescents.

DOI: https://doi.org/10.3345/cep.2021.00213

Nephrology (Genitourinary)

Blood pressure measurements and hypertension in infants, children, and adolescents: from the postmercury to mobile devices (1,521 times)

Seon Hee Lim, Seong Heon Kim

Clin Exp Pediatr. 2022;65(2):73-80. Published online September 15, 2021

Cited By 2

· 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.

DOI: https://doi.org/10.3345/cep.2021.00143

Original Article

Neonatology (Perinatology)

Neonatal sepsis-causing bacterial pathogens and outcome of trends of their antimicrobial susceptibility a 20-year period at a neonatal intensive care unit (1,521 times)

Woo Sun Song, Hye Won Park, Moon Youn Oh, Jae Young Jo, Chae Young Kim, Jung Ju Lee, Euiseok Jung, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim

Clin Exp Pediatr. 2022;65(7):350-357. Published online December 9, 2021

Cited By 2

Question: What is prevalence of bacterial pathogens causing sepsis and their antimicrobial susceptibility over 20 years?
Finding: Coagulase-negative remains most common causative organism. The most common gram-negative organism was Klebsiella pneumonia. The susceptibility of staphylococcus aureus and K. pneumonia showed increased susceptability to oxacillin, cefotaxime and amikacin, gentamicin, respectively.
Meaning: Answers to the question asked is important in choosing antimicrobials and to monitor emergence of multidrug-resistant organisms.

DOI: https://doi.org/10.3345/cep.2021.00668

Retraction Notice

Coronavirus disease 2019 in a 2-month-old male infant: a case report from Iran (1,477 times)

Hosein Heydari, Seyed Kamal Eshagh Hossaini, Ahmad Hormati, Mahboubeh Afifian, Sajjad Ahmadpour

Clin Exp Pediatr. 2022;65(8):417-417. Published online July 19, 2022

DOI: https://doi.org/10.3345/cep.2020.00941.r1
Retracts: Clin Exp Pediatr 2020;63(12):499

Original Article

Oncology

Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand (1,464 times)

Kunanya Suwannaying, Piti Techavichit, Patcharee Komvilaisak, Napat Laoaroon, Nattee Narkbunnam, Kleebsabai Sanpakit, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Lalita Sathitsamitphong, Chalongpon Santong, Panya Seksarn, Suradej Hongeng, Surapon Wiangnon

Clin Exp Pediatr. 2022;65(9):453-458. Published online May 24, 2022

Question: This study aimed to elucidate the outcomes of high-risk neuroblastoma (HR-NB) patients treated with high-dose chemotherapy and stem cell rescue without immunotherapy.
Finding: The 5-year overall survival and event-free survival rates were 45.1% and 40.4%, respectively.
Meaning: High-dose chemotherapy plus stem cell rescue followed by cis-retinoic acid for 12 months is well tolerated and could improve survival in patients with HR-NB in limited resource settings.

DOI: https://doi.org/10.3345/cep.2022.00437

Review Article

Endocrinology

Genetic factors in precocious puberty (1,408 times)

Young Suk Shim, Hae Sang Lee, Jin Soon Hwang

Clin Exp Pediatr. 2022;65(4):172-181. Published online October 18, 2021

Cited By 5

· 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

DOI: https://doi.org/10.3345/cep.2021.00521

Critical Care Medicine

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis (1,402 times)

Silver Heinsar, Sainath Raman, Jacky Y. Suen, Hwa Jin Cho, John F. Fraser

Clin Exp Pediatr. 2021;64(5):188-195. Published online August 10, 2020

Cited By 4

Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation...

DOI: https://doi.org/10.3345/cep.2020.00836

Infection

Recommendation for use of diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b conjugate, and hepatitis B vaccine in infants (1,398 times)

Hye-Kyung Cho, Su Eun Park, Yae-Jean Kim, Dae Sun Jo, Yun-Kyung Kim, Byung-Wook Eun, Taek-Jin Lee, Jina Lee, Hyunju Lee, Ki Hwan Kim, Eun Young Cho, Jong Gyun Ahn, Eun Hwa Choi; The Committee on Infectious Diseases of the Korean Pediatric Society

Clin Exp Pediatr. 2021;64(12):602-607. Published online June 8, 2021

∙ Diphtheria and tetanus toxoids and acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) was licensed in Korea in April 2020.
∙ DTaP-IPV-Hib-HepB is indicated as a 3-dose primary series for infants aged 2, 4, and 6 months who received the standalone HepB vaccine at birth.
∙ Infants born to HepB surface antigen-positive mothers are currently recommended to be immunized with HepB immunoglobulin at birth and then monovalent HepB vaccine at 0, 1, and 6 months.

DOI: https://doi.org/10.3345/cep.2021.00507

Original Article

Neonatology (Perinatology)

Fluconazole prophylaxis against invasive candidiasis in very low and extremely low birth weight preterm neonates: a systematic review and meta-analysis (1,395 times)

Mahmoud Robati Anaraki, Masoud Nouri-Vaskeh, Shahram Abdoli Oskoei

Clin Exp Pediatr. 2021;64(4):172-179. Published online May 14, 2020

Cited By 4

· Mortality is decreased significantly in meta-analysis of studies in different regimen of fluconazole prophylaxis.
· Significant decrease was seen in incidence of invasive candidiasis-associated mortality in extremely low birth weight infants in same schedules of prophylaxis.
· More studies required to relief the concerns.

DOI: https://doi.org/10.3345/cep.2019.01431

Review Article

Cardiology

Implication of microRNA as a potential biomarker of myocarditis (1,393 times)

Jin-Hee Oh, Gi Beom Kim, Heeyoung Seok

Clin Exp Pediatr. 2022;65(5):230-238. Published online March 2, 2022

Cited By 3

· 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.

DOI: https://doi.org/10.3345/cep.2021.01802

Clinical note

Neurology

Myelin oligodendrocyte glycoprotein antibody encephalitis following severe acute respiratory syndrome coronavirus 2 in a pediatric patient (1,383 times)

Nusrat Ahsan, Saba Jafarpour, Jonathan D. Santoro

Clin Exp Pediatr. 2021;64(6):310-312. Published online February 1, 2021

Cited By 9

Question: Although neurologic complications have been reported during the acute phase of infection in children, less is known about the postinfectious phenomenon associated with the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) virus.
Finding: We present a case of a 7-year-old female with a prior asymptomatic infection with SARS-CoV-2 who subsequently developed encephalopathy and status epilepticus in association with myelin oligodendrocyte glycoprotein (MOG) antibody positivity.
Meaning: Here we present the first case of postinfectious of a MOG spectrum disorder associated with prior SARS-CoV-2 infection in a pediatric patient.

DOI: https://doi.org/10.3345/cep.2020.01963

Review Article

Nephrology (Genitourinary)

Obesity and chronic kidney disease: prevalence, mechanism, and management (1,365 times)

Hyung Eun Yim, Kee Hwan Yoo

Clin Exp Pediatr. 2021;64(10):511-518. Published online April 6, 2021

Cited By 5

· Obesity is strongly associated with the development and progression of chronic kidney disease.
· Altered renal hemodynamics, metabolic effects, and lipid nephrotoxicity may play a key role in the development of obesity-related kidney disease.
· Children born to obese mothers are at increased risk of developing obesity and chronic kidney disease later in life.
· A multilevel approach is needed to prevent obesity and related chronic diseases.

DOI: https://doi.org/10.3345/cep.2021.00108

Editorial

Cardiology

Characteristics of z score systems for diagnosing coronary abnormalities in Kawasaki disease (1,338 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.

DOI: https://doi.org/10.3345/cep.2021.01886

Original Article

Neonatology (Perinatology)

Predictive factors of death in neonates with hypoxic-ischemic encephalopathy receiving selective head cooling (1,324 times)

Behnaz Basiri, Mohammadkazem Sabzehei, Mohammadmahdi sabahi

Clin Exp Pediatr. 2021;64(4):180-187. Published online August 27, 2020

Cited By 3

Question: What is the most important factor that increases mortality in infants with hypoxic-ischemic encephalopathy (HIE) who receive selective head cooling?
Finding: All cases of neonatal mortality were severe HIE (stage 3), and a severely abnormal amplitude-integrated electroencephalography and mortality were increased with the need for advanced neonatal resuscitation upon delivery.
Meaning: Advanced neonatal resuscitation affects HIE outcomes, and medical personnel should be prepared to provide the best intervention.

DOI: https://doi.org/10.3345/cep.2019.01382

Review Article

Neurology

Big data analysis and artificial intelligence in epilepsy – common data model analysis and machine learning-based seizure detection and forecasting (1,322 times)

Yoon Gi Chung, Yonghoon Jeon, Sooyoung Yoo, Hunmin Kim, Hee Hwang

Clin Exp Pediatr. 2022;65(6):272-282. Published online November 26, 2021

Cited By 2

· Big data analysis, such as common data model and artificial intelligence, can solve relevant questions and improve clinical care.
· Recent deep learning studies achieved 0.887–0.996 areas under the receiver operating characteristic curve for automated interictal epileptiform discharge detection.
· Recent deep learning studies achieved 62.3%–99.0% accuracy for interictal-ictal classification in seizure detection and 75.0%– 87.8% sensitivity with a 0.06–0.21/hr false positive rate in seizure forecasting.

DOI: https://doi.org/10.3345/cep.2021.00766

Original Article

Gastroenterology

Ability of polymicrobial probiotic and mono-strain probiotic to reduce functional abdominal pain in children: a randomized clinical trial (1,318 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.

DOI: https://doi.org/10.3345/cep.2022.00339

Editorial

Neonatology (Perinatology)

Factors to consider before implementing telemedicine protocols to manage neonatal jaundice (1,317 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.

DOI: https://doi.org/10.3345/cep.2022.00227

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 (1,315 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

Cited By 9

· 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.

DOI: https://doi.org/10.3345/cep.2020.01312

Original Article

General Pediatrics

Effect of maternal and child factors on stunting: partial least squares structural equation modeling (1,306 times)

Agus Santosa, Essa Novanda Arif, Dinal Abdul Ghoni

Clin Exp Pediatr. 2022;65(2):90-97. Published online May 4, 2021

Cited By 6

Question: What effects do maternal and child factors have on stunting? Are there significant indicators of stunting?
Finding: Child and maternal factors had 49.8% and 30.3% effects on stunting, respectively. The primary child factor was infant formula dose, while the primary maternal factor was nutritional status.
Meaning: More attention to nutritional status during pregnancy and ensuring the appropriate dose of infant formula at ages 6–24 months can prevent stunting.

DOI: https://doi.org/10.3345/cep.2021.00094

Review Article

Allergy

Diagnosis and management of asthma in infants and preschoolers (1,301 times)

Hai Lee Chung

Clin Exp Pediatr. 2022;65(12):574-584. Published online April 19, 2022

Cited By 2

· 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.

DOI: https://doi.org/10.3345/cep.2021.01746

Original Article

Nephrology (Genitourinary)

Urinary neutrophil gelatinase-associated lipocalin: a marker of urinary tract infection among febrile children (1,276 times)

Ji Hyun Moon, Kee Hwan Yoo, Hyung Eun Yim

Clin Exp Pediatr. 2021;64(7):347-354. Published online October 17, 2020

Cited By 4

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.

DOI: https://doi.org/10.3345/cep.2020.01130

Gastroenterology

Noninvasive markers for esophageal varices in children with cirrhosis (1,271 times)

Parisa Rahmani, Fatemeh Farahmand, Ghobad Heidari, Azadeh Sayarifard

Clin Exp Pediatr. 2021;64(1):31-36. Published online July 21, 2020

Cited By 5

Question: Can noninvasive biomarkers identify esophageal varices among children with esophageal cirrhosis?
Finding: The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index, platelet count to spleen size ratio, and risk score differed significantly between the patients with and those without esophageal varices.
Meaning: These biological parameters can predict esophageal varices among pediatric patients and indicate the need for esophagogastroduodenoscopy.

DOI: https://doi.org/10.3345/cep.2019.01599

Pulmonology

Modified high-flow nasal cannula for children with respiratory distress (1,260 times)

Sarocha Itdhiamornkulchai, Aroonwan Preutthipan, Jarin Vaewpanich, Nattachai Anantasit

Clin Exp Pediatr. 2022;65(3):136-141. Published online May 24, 2021

Question: Can the modified high-flow nasal cannula (HFNC) provide alternative respiratory support for children with acute respiratory distress?
Finding: A total of 74 patients were assigned to the modified or commercial HFNC groups. The intubation rate, length of hospital stay, and adverse events did not differ between the 2 groups.
Meaning: The modified HFNC can provide alternative respiratory support for pediatric respiratory distress.

DOI: https://doi.org/10.3345/cep.2020.01403

Review Article

Neurobehavior

Jeopardized mental health of children and adolescents in coronavirus disease 2019 pandemic (1,224 times)

Bohyun Jin, Sohee Lee, Un Sun Chung

Clin Exp Pediatr. 2022;65(7):322-329. Published online June 3, 2022

Cited By 3

∙ The coronavirus disease 2019 (COVID-19) pandemic has required preventive measures like self-quarantine, school closures, and lockdown, which ultimately make youth directly and indirectly vulnerable to depression, anxiety, posttraumatic stress disorder, and somatization.
∙ Child abuse is more common in the COVID-19 era than previously.
∙ Pediatricians should carefully examine parental and child mental health to directly and indirectly aid their physical and mental health.

DOI: https://doi.org/10.3345/cep.2021.01753

Editorial

Pulmonology

Influence of coronavirus disease 2019 pandemic on respiratory health in children (1,212 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.

DOI: https://doi.org/10.3345/cep.2022.00192

Original Article

Other

Association between pesticide and polychlorinated biphenyl exposure during pregnancy and autism spectrum disorder among children: a meta-analysis (1,210 times)

Fereshteh Mehri, Saeid Bashirian, Salman khazaei, Ensiyeh Jenabi

Clin Exp Pediatr. 2021;64(6):286-292. Published online July 27, 2020

· This meta-analysis analyzed the association between pesticide and polychlorinated biphenyl (PCB) exposure during pregnancy and autism spectrum disorders (ASD) risk among children.
· A significant association was noted between PCB and pesticide exposure during pregnancy and ASD risk among children (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.26–2.34 and OR, 1.20; 95% CI, 1.02–1.39), respectively.
· Pesticide and PCB exposure during pregnancy may affect ASD risk among children.

DOI: https://doi.org/10.3345/cep.2020.00864

Review Article

Cardiology

Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections (1,205 times)

Young Hwan Lee

Clin Exp Pediatr. 2023;66(1):1-11. Published online June 22, 2022

· The etiology of Kawasaki disease (KD) is unclear, but its clinical, epidemiological, and pathophysiological characteristics are strongly associated with infectious diseases.
· In the coronavirus disease 2019 pandemic era, viruses are attracting the most attention. Sudden acute respiratory syndrome coronavirus 2 infection causes various hyperinflammation in children that require differentiation from KD.
· Immune responses in patients with KD may be induced by host cell damage. To effectively prevent and treat KD, the genetic background and immune responses of KD patients and triggering pathogens require identification.

DOI: https://doi.org/10.3345/cep.2022.00150

Clinical Note

Endocrinology

Graves’ disease: an uncommon cause of late sequelae following DRESS (drug reaction with eosinophilia and systemic symptoms) (1,205 times)

Therdpong Tempark, Amatanun Tangthanapalakul, Tawatchai Deekajorndech, Susheera Chatproedprai, Vichit Supornsilchai, Siriwan Wananukul

Clin Exp Pediatr. 2022;65(12):602-604. Published online June 22, 2022

Cited By 1

DOI: https://doi.org/10.3345/cep.2022.00381

Review Article

Hematology

Thrombosis and severe acute respiratory syndrome coronavirus 2 vaccines: vaccine-induced immune thrombotic thrombocytopenia (1,200 times)

Young Shil Park

Clin Exp Pediatr. 2021;64(8):400-405. Published online June 30, 2021

Cited By 3

· 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.

DOI: https://doi.org/10.3345/cep.2021.00717

Original Article

Neurobehavior

Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis (1,200 times)

Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei

Clin Exp Pediatr. 2023;66(2):70-75. Published online August 17, 2022

Cited By 1

Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I²=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.

DOI: https://doi.org/10.3345/cep.2022.00108

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Cited By 10	Food allergies and food-induced anaphylaxis: role of cofactors
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