Clinical and Experimental Pediatrics

Original Article

Hematology

Hyperhomocysteinemia in pediatric β-thalassemia: links to vitamin cofactor deficiencies and oxidative stress (4,574 times)

Arzu Dadashova, Gunay Aliyeva, Rana Rahimova, Gulnara Azizova, Khayala Mammadova

Clin Exp Pediatr. 2025;68(10):819-830. Published online July 8, 2025

Web of Science 1 Crossref 3

Question: What are the biochemical and clinical correlates of hyperhomocysteinemia in pediatric β-thalassemia, and how does it relate to vitamin status, oxidative stress, and splenectomy?
Finding: Most pediatric β-thalassemia patients exhibited severe hyperhomocysteinemia, which was strongly associated with folate and B₁₂ deficiencies and influenced oxidative stress patterns, particularly in splenectomized individuals.
Meaning: These findings suggest that routine monitoring and correction of B-vitamin deficiencies may mitigate hyperhomocysteinemia-related risks in pediatric thalassemia.

DOI: https://doi.org/10.3345/cep.2025.00556

Nephrology (Genitourinary)

C3 glomerulopathy in children: experience at a resource-limited center (4,537 times)

Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan

Clin Exp Pediatr. 2025;68(4):311-318. Published online November 28, 2024

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2024.01256

Critical Care Medicine

Serum amyloid A and proadrenomedullin as early markers in critically ill children with sepsis (4,469 times)

Nagwan Y. Saleh, Wafaa M. Abo El Fotoh, Mona S. Habib, Salem E. Deraz

Clin Exp Pediatr. 2025;68(8):578-586. Published online February 26, 2025

Question: Are serum amyloid A (SAA) and proadrenomedullin (proADM) levels early markers in critically ill children with sepsis?
Finding: This prospective case-control study included 65 critically ill children with sepsis admitted to the pediatric intensive care unit and 31 controls. SAA and proADM levels were significantly higher in patients versus controls.
Meaning: SAA and proADM are promising biomarkers for diagnosing and predicting outcomes in pediatric sepsis.

DOI: https://doi.org/10.3345/cep.2024.01928

Review Article

Immunology

NLRP3 inflammasome: a key player in neonatal brain injury (4,466 times)

Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc

Clin Exp Pediatr. 2025;68(7):475-485. Published online April 1, 2025

Web of Science 1 Crossref 1

Hypoxic-ischemic encephalopathy is the major cause of neonatal brain injury. NOD-like receptor family pyrin domain containing 3 inflammasome activation leads to neuroinflammation, which significantly affects newborn mortality. The establishment of preventive and therapeutic strategies against brain damage requires a thorough understanding of the mechanisms underlying neuroinflammation and inflammasome activation in the neonatal brain.

DOI: https://doi.org/10.3345/cep.2024.01935

Adolescence Medicine

Diet-related behaviors affecting health and substance use among children and adolescents (4,408 times)

Ji-Hyun Seo, Sochung Chung

Clin Exp Pediatr. 2024;67(12):664-671. Published online October 31, 2024

Web of Science 1 Crossref 1

· Diet behaviors in children and adolescents are influenced by environmental and sociocultural factors.
· Unhealthy diet behaviors and poor diet quality are the main contributing factors to noncommunicable diseases and mental health problems during childhood and adolescence.
· Smoking and alcohol drinking in children and adolescents may be associated with unhealthy diet behavior or poor diet quality.

DOI: https://doi.org/10.3345/cep.2023.01634

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 (4,358 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

Web of Science 2 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2025.00416

Review Article

Allergy

Recent advances in food allergen immunotherapy (4,334 times)

You Hoon Jeon, Edwin H. Kim

Clin Exp Pediatr. 2024;67(8):386-394. Published online December 7, 2023

Web of Science 1 Crossref 1

· To enhance the safety of food allergen immunotherapy, alternative approaches such as sublingual immunotherapy, epicutaneous immunotherapy, low-dose oral immunotherapy (OIT), and omalizumab with OIT are being explored.
· Factors such as causative allergen type, natural outgrowth, symptom severity, and patient age should be considered.
· Individualized food allergen immunotherapy plans should be established to determine the most beneficial treatment for each patient.

DOI: https://doi.org/10.3345/cep.2023.01004

Other

MicroRNAs as novel biomarkers for the diagnosis and treatment of pediatric diseases (4,321 times)

Hwal Rim Jeong, Il Tae Hwang

Clin Exp Pediatr. 2024;67(3):119-125. Published online May 24, 2023

Web of Science 10 Crossref 9

MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression post transcriptionally, and MiRNA expression levels vary with developmental stages. MiRNAs play an important role in several biological processes in children, including growth, neuro-development, inflammation, and tumor formation. Research on miRNAs may uncover the molecular mechanisms underlying various pediatric diseases, leading to the development of novel biomarkers that aid in the diagnosis, treatment, and prognosis of these diseases.

DOI: https://doi.org/10.3345/cep.2023.00171

Endocrinology

Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis (4,288 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

Crossref 2

· 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.

DOI: https://doi.org/10.3345/cep.2023.01536

Original Article

Pulmonology

Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study (4,264 times)

Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran

Clin Exp Pediatr. 2025;68(4):319-325. Published online November 13, 2024

Web of Science 1 Crossref 1

Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations?
Finding: Preschool children with obesity exhibit impaired lung function characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of such changes.
Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function.

DOI: https://doi.org/10.3345/cep.2024.01053

Review Article

Neonatology (Perinatology)

Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants (4,230 times)

Eduardo Cuestas, Alina Rizzotti

Clin Exp Pediatr. 2025;68(4):287-297. Published online December 23, 2024

Web of Science 1 Crossref 2

· Previous reviews of extrauterine growth restriction focused mainly on weight growth restriction caused by nutritional factors or pathological conditions.
· This review summarizes recent developments in the pathophysiology of nonnutritional length growth restriction in very preterm infants with focus on the impact of sustained neonatal inflammation on their short- and long-term outcomes.
· Further research is needed to investigate optimal strategies to improve length growth restriction in very preterm infants.

DOI: https://doi.org/10.3345/cep.2024.01354

Original Article

Pulmonology

Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the United States: a cross-sectional study (4,211 times)

Chuhan Cheng, Liyan Zhang

Clin Exp Pediatr. 2025;68(7):489-496. Published online March 11, 2025

Web of Science 1 Crossref 2

Question: Is there a nonlinear relationship between neutrophil-to-lymphocyte ratio (NLR) and asthma in children and adolescents?
Finding: NLR showed a nonlinear association with asthma, with an NLR threshold of 2.23 identifying individuals at higher risk.
Meaning: An NLR<2.23 may serve as a potential biomarker for asthma risk assessment and management in pediatric populations, thereby offering a simple tool for the early identification of at-risk individuals.

DOI: https://doi.org/10.3345/cep.2024.01844

Editorial

Neurology

Screen time and neurodevelopment in preschoolers: addressing a growing concern in pediatric practice (4,155 times)

Soongang Park, Hyewon Woo

Clin Exp Pediatr. 2025;68(6):434-436. Published online January 13, 2025

· Excessive screen time in preschoolers is associated with neurodevelopmental delays, particularly during the early years of life.
· Parental supervision and national guidelines are critical in mitigating the negative impacts of excessive screen time and fostering healthy media habits in preschoolers.

DOI: https://doi.org/10.3345/cep.2024.01536

Letter to the Editor

General Pediatrics

Vitamin B₁₂ deficiency in anemic children before versus after age 2 years: a form of hidden hunger in India (4,086 times)

Sahil Goel, Ruchika Bhatnagar, Anita Kumari, Brig Prem Lochan Prasad, Lahar Sahai

Clin Exp Pediatr. 2024;67(2):116-118. Published online January 24, 2024

DOI: https://doi.org/10.3345/cep.2023.01347

Original Article

Developmental and Behavioral Medicine

Neonatal risk factors associated with autism spectrum disorders: an umbrella review (4,081 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

Web of Science 5 Crossref 5

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.

DOI: https://doi.org/10.3345/cep.2024.00136

Immunology

Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus (4,043 times)

Soyoung Lee, Kyung-Hyo Kim, Ji Hyen Lee, Han Wool Kim

Clin Exp Pediatr. 2025;68(5):362-369. Published online January 13, 2025

Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics?
Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative.
Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations.

DOI: https://doi.org/10.3345/cep.2024.01151

Editorial

Neonatology (Perinatology)

Intermittent sigh breaths during high-frequency oscillatory ventilation among newborn infants (4,010 times)

Ga Won Jeon

Clin Exp Pediatr. 2025;68(7):486-488. Published online April 16, 2025

Intermittent sigh breaths during high-frequency oscillatory ventilation can improve ventilation and oxygenation by enhancing lung recruitment. Although research on this approach in newborn infants is limited, some published studies suggest that sigh breaths are generally applied at a rate of 2–3 breaths/min with an inspiratory time of 0.5–1 second and pressure of current mean airway pressure + 5 cmH₂O (maximum, 30 cmH₂O).

DOI: https://doi.org/10.3345/cep.2025.00549

Review Article

Neonatology (Perinatology)

Quantifying myelin in neonates using magnetic resonance imaging: a systematic literature review (3,978 times)

Nabila Hanem Arshad, Hasyma Abu Hassan, Nur Farhayu Omar, Zurina Zainudin

Clin Exp Pediatr. 2024;67(8):371-385. Published online December 6, 2023

Web of Science 1

Question: This systematic review attempts to discover the best magnetic resonance imaging (MRI) technique for myelin quantification in neonates by evaluating various MRI parameters and their reproducibility.
Finding: Since the benefits of using synthetic MRI for quantifying myelin in neonates outweigh the very minor draw- backs, it is recommended.
Meaning: The findings suggest the importance of identifying noninvasive MRI techniques available to assess myelin tissue in neonates, which aid in diagnosing neurodevelopmental disorders.

DOI: https://doi.org/10.3345/cep.2023.00514

Original Article

Nutrition

Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach (3,944 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

Web of Science 1

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.

DOI: https://doi.org/10.3345/cep.2023.01375

General Pediatrics

The role of serum zinc and selenium levels in etiology of febrile seizures (3,937 times)

Yavuz Ataş, Hatice Gamze Poyrazoğlu

Clin Exp Pediatr. 2025;68(5):388-394. Published online January 13, 2025

Web of Science 1 Crossref 1

Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes.

DOI: https://doi.org/10.3345/cep.2024.01410

Other

Balance assessment with decreased base of support for children with disabilities (3,914 times)

Guilherme M. Cesar, Madison Giebler, Thad W. Buster, Judith M. Burnfield

Clin Exp Pediatr. 2024;67(12):718-724. Published online November 11, 2024

Question: Can a balance task with narrowed base of support indicate overall functional balance control in children with disabilities?
Finding: While single-limb standing could explain overall balance control for children with disabilities, it was unrelated with balance control for typically developing children.
Meaning: One balance task with narrowed base of support can be used as practical assessment of balance abilities for children with disabilities when allocated session time is of concern.

DOI: https://doi.org/10.3345/cep.2024.00780

Endocrinology

Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency (3,899 times)

Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul

Clin Exp Pediatr. 2025;68(3):238-246. Published online November 13, 2024

Web of Science 1 Crossref 2

Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population?
Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change.
Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development.

DOI: https://doi.org/10.3345/cep.2024.01060

Hematology

Impact of Xmn1 polymorphism on hydroxyurea therapy in children with HbE-β non-transfusion dependent thalassemia: a cohort study (3,875 times)

Saheli Roy, Paramita Bhattacharya, Atanu Kumar Dutta, Mrinal Kanti Das

Clin Exp Pediatr. 2025;68(6):437-444. Published online February 3, 2025

Question: Does the T allele of Xmn1 polymorphism favorably influence hydroxyurea efficacy in children of Eastern descent with fetal hemoglobin (HbE)-β nontransfusion dependent thalassemia (NTDT)?
Finding: Decrease in transfusion requirement and increase in height following hydroxyurea therapy was noted in both groups, however, change in CT was more critical than that in CC genotype.
Meaning: T allele of Xmn1 polymorphism favorably influences hydroxyurea efficacy in children with HbE-β NTDT.

DOI: https://doi.org/10.3345/cep.2024.01284

Other

Impact of thyroid hormones and serum endothelin levels on pediatric asthma control: a case-control study of an Indian population (3,847 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.

DOI: https://doi.org/10.3345/cep.2025.00143

Gastroenterology

Somatic symptom severity during acute illnesses among children with functional gastrointestinal disorders (3,837 times)

Rattanachart Sirinil, Anundorn Wongteerasut

Clin Exp Pediatr. 2025;68(8):587-593. Published online March 11, 2025

Functional gastrointestinal disorders (FGIDs) are associated with various somatic symptoms measured using a visual analogue scale and the Children’s Somatic Symptoms Inventory-24 questionnaire. Children with FGIDs exhibited more significant somatic symptoms than controls during acute illnesses. Gastrointestinal (GI) and non-GI manifestations are significantly more common in children with FGIDs.

DOI: https://doi.org/10.3345/cep.2024.01795

Review Article

Developmental and Behavioral Medicine

Effect of pesticide exposure on stunting incidence: a systematic review and meta-analysis (3,757 times)

Sani Rachman Soleman, Yaltafit Abror Jeem, Muhammad Fathi Banna Al Faruqi, Mahdea Kasyiva, Vita Widyasari, Kuswati Kuswati, Nur Aini Djunet, Muflihah Rizkawati, Ety Sari Handayani

Clin Exp Pediatr. 2024;67(10):510-518. Published online September 24, 2024

Web of Science 1 Crossref 1

This review aimed to determine whether pesticide exposure is associated with stunting in children. The 13 included studies agree that pesticide exposure is not correlated with stunting incidence regardless of substance type (organophosphate and pyrethroid). Heterogeneity appeared with age covariate as potential confounding. The evidence of this study is challeng-ing, as the adverse effects of pesticides grossly occurred. The protection of children is warranted for preventing future neurodevelopment issues.

DOI: https://doi.org/10.3345/cep.2023.01522

Perspective

General Pediatrics

Navigating the complex behavioral landscape of children in foster care and adopted families (3,747 times)

Anisha Choi, Sandhya J. Kadam

Clin Exp Pediatr. 2025;68(8):620-623. Published online May 12, 2025

DOI: https://doi.org/10.3345/cep.2025.00822

Review Article

Rheumatology

Double-negative T cells in pediatric rheumatic diseases (3,742 times)

Dimitri Poddighe, Tilektes Maulenkul, Kuanysh Dossybayeva, Gulsamal Zhubanova, Zaure Mukusheva, Lyudmila Akhmaltdinova

Clin Exp Pediatr. 2024;67(12):632-640. Published online September 12, 2024

Web of Science 4 Crossref 5

Double-negative T (DNT) cells appear to be increased in several pediatric rheumatic diseases and this finding may be correlated with disease activity to some extent. However, due to significant heterogeneity in several methodological aspects, further investigations in rheumatic children are needed to assess the potential relevance of DNT cells as biomarkers and clarify their immunopathological role.

DOI: https://doi.org/10.3345/cep.2023.01760

Original Article

Neonatology (Perinatology)

Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status (3,735 times)

Sung-Hoon Chung, Chae Young Kim, Yong-Sung Choi, Myung Hee Lee, Jae Woo Lim, Byong Sop Lee, Ki-Soo Kim; the Korean Neonatal Network

Clin Exp Pediatr. 2024;67(11):619-627. Published online September 12, 2024

Web of Science 2 Crossref 3

Question: How do structural and staffing characteristics of neonatal intensive care units (NICUs) influence the mortality rates of very low birth weight infants (VLBWIs)?
Findings: NICUs with higher staffing levels, particularly with more neonatologists, and those offering advanced care levels were associated with lower mortality rates. Additionally, regional disparities were observed, with some areas demon-strating significantly higher survival rates.
Meaning: Adequate staffing and equitable regional distribution of medical resources are crucial for improving survival outcomes in VLBWIs. Efforts to enhance NICU staffing and address regional healthcare disparities are essential for optimizing care quality and reducing mortality in this vulnerable population.

DOI: https://doi.org/10.3345/cep.2023.01613

Review Article

Endocrinology

Impact of hematopoietic stem cell transplantation on growth outcomes in mucopolysaccharidosis: a systematic review (3,714 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.

DOI: https://doi.org/10.3345/cep.2024.01725

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