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"Most viewed" Articles are from the articles published in 2021 during the last six month.

Editorial
Neurology
Recent studies are focus on the new treatments for hypoxicischemic encephalopathy (HIE) and long-term outcomes in later childhood and adolescence in children with a history on HIE   (708 times)
Eun Sook Suh
Clin Exp Pediatr. 2021;64(12):628-629.   Published online September 30, 2021
Neonatal encephalopathy is the most important reason for morbidity and mortality. The early detection of neonate with high risk for hypoxic ischemic encephalopathy (HIE) and treatment are important for prevent long term complication. Hypothermia is currently standard treatment option for HIE. Several clinical studies have been performed due to improve the long term outcome. New therapeutic options including xenon, allopurinol, erythropoietin, topiramate will help to reduce neuropsychiatric disability.
Clinical Note
Neonatology (Perinatology)
Secondary renal tubular dysgenesis in a newborn exposed to angiotensin Ⅱ receptor antagonist during gestation   (707 times)
Mi Hyeon Gang, Yong Wook Lee, Mea-young Chang
Clin Exp Pediatr. 2021;64(3):136-138.   Published online July 21, 2020
Question: The use of renin-angiotensin system (RAS) blockers during pregnancy causes lethal neonatal complications.
Finding: A neonate, whose mother took a RAS blocker during pregnancy, was diagnosed with renal tubular dysgenesis. He presented with respiratory failure, severe refractory hypotension, and anuria requiring continuous dialysis.
Meaning: Physicians should consider any degree of RAS fetopathy in a newborn born to a hypertensive mother who had use of RAS blockers during her pregnancy.
Original Article
Allergy
Sex-based differences in factors associated with bronchial hyperresponsiveness in adolescents with childhood asthma   (707 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   (703 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.
Perspective
Neurology
How can pediatricians treat neurodevelopmental disorders   (702 times)
Young-Hoon Kim
Clin Exp Pediatr. 2021;64(1):1-2.   Published online July 27, 2020
∙ Recently neurodevelopmental therapy for preschool-aged children with neurodevelopmental disorders is paid for by health insurance in Korea.
∙ There are good evidences that parenting programs and neurodevelopmental therapy can work in attention deficit hyperactivity disorder and autism spectrum disorder.
∙ Pediatricians must be able to pass away important information to parents.
Review Article
Infection
Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia   (702 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.
Editorial
Other
Global trend and disparity of acute lower respiratory infection as cause of mortality in children under 5 years of age   (701 times)
Abdul Wahab
Clin Exp Pediatr. 2021;64(12):630-631.   Published online June 11, 2021
Acute lower respiratory infection (ALRI) is the leading cause of death among children under 5 years of age worldwide, especially in low- and middle-income countries. A spatial analysis explains the trends and severity based on the conditions of each country. Countries in Asia and Africa experience many cases of mortality caused by ALRI.
Review Article
Cardiology
Pediatric heart transplantation: how to manage problems affecting long-term outcomes?   (683 times)
Young Hwue Kim
Clin Exp Pediatr. 2021;64(2):49-59.   Published online April 8, 2020
Since the initial International Society of Heart Lung Transplantation registry was published in 1982, the number of pediatric heart transplantations has increased markedly, reaching a steady state of 500–550 transplantation annually and occupying up to 10% of total heart transplantations. Heart transplantation is considered an established therapeutic option for patients with end-stage heart disease. The long-term outcomes of pediatric heart...
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?   (680 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.
Letter to the Editor
Other
Evaluation of simulation-based ultrasound course for pediatricians: a starting point for future training curriculum   (678 times)
Chon In Kuok, Avis Siu Ha Leung, Jonan Chun Yin Lee, Winnie Kwai Yu Chan
Clin Exp Pediatr. 2022;65(1):53-55.   Published online July 28, 2021
Question: Simulation-based ultrasound training is becoming more popular. Is there a role for pediatricians in such training programs?
Finding: Our program received promising feedback from its participants. Self-rated confidence in image interpretation and ultrasound-guided catheter insertion improved after the simulation. Participants reported a higher preference for performing ultrasound scans before radiologist assessment.
Meaning: Ultrasound training can be considered as part of the pediatric training curriculum in the future.
Clinical Note
Rheumatology
Haploinsufficiency A20 misdiagnosed as PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome with Kikuchi disease   (675 times)
Kyo Jin Jo, Su Eun Park, Chong Kun Cheon, Seung Hwan Oh, Seong Heon Kim
Clin Exp Pediatr. 2023;66(2):82-84.   Published online June 22, 2022
Letter to the Editor
Allergy
Environmental and dietary factors to be checked for treatment of atopic dermatitis in rural children   (658 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.
Editorial
Allergy
Dietary restriction misconceptions and food allergy education in children with atopic dermatitis   (654 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.
Original Article
Nephrology (Genitourinary)
Expression profiling of cultured podocytes exposed to nephrotic plasma reveals intrinsic molecular signatures of nephrotic syndrome   (648 times)
Stuti Panigrahi, Varsha Chhotusing Pardeshi, Karthikeyan Chandrasekaran, Karthik Neelakandan, Hari PS, Anil Vasudevan
Clin Exp Pediatr. 2021;64(7):355-363.   Published online November 1, 2020
Question: Is it possible to classify nephrotic syndrome (NS) through gene expression profiling of podocytes exposed to NS plasma?
Finding: Our data showed different expression profiles in podocytes exposed to nephrotic plasma from different clinical groups, suggesting the molecular stratification of patients into intrinsic subtypes.
Meaning: Transcriptome profiling of podocytes treated with NS plasma can stratify patients into intrinsic subtypes and provide insight into the molecular mechanisms of podocyte injury.
Clinical note
Immunology
Salivary and lacrimal gland enlargement with serum immunoglobulin G4 elevation   (647 times)
Jinseok Lee, Da-Eun Kim, Jeong-Hwan Yang, Misun Lim, Hye Yung Yum, JoongGon Kim
Clin Exp Pediatr. 2021;64(2):93-95.   Published online December 8, 2020
Question: What diseases should be considered in a 15-year-old girl presenting enlarged lacrimal and salivary glands?
Finding: Laboratory tests revealed elevated IgG4 levels. A submandibular gland biopsy showed lymphoplasmacytic infiltration and more than 40 immunoglobulin G4 (IgG4)-positive cells per high-power field. The patient was diagnosed with IgG4-related disease.
Meaning: Although rare in children, IgG4-related disease should be considered a differential diagnosis in children with enlarged salivary and lacrimal glands.
Letter to the Editor
Infection
Multisystem inflammatory syndrome in children and Kawasaki disease in infants: 2 sides of the same coin?   (646 times)
Hing Cheong Kok, Dinesh Nair, Ke Juin Wong, Siew Moy Fong
Clin Exp Pediatr. 2021;64(11):599-601.   Published online October 7, 2021
Question: Are multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) in infants, 2 sides of the same coin?
Finding: Here we report on a 4-month-old girl with MIS-C and signs of KD with shock. Most (83%) infants with MIS-C had features of KD, especially KD shock syndrome.
Meaning: MIS-C is similar to KD, and likely is a consequence of dysregulated immune responses secondary to sudden acute respiratory syndrome coronavirus 2 infection.
Original Article
Gastroenterology
Association between maternal weight gain during pregnancy and child’s body mass index at preschool age   (646 times)
Jeewon Shin, Yoowon Kwon, Ju Hee Kim, Su Jin Jeong
Clin Exp Pediatr. 2023;66(2):76-81.   Published online November 30, 2022
Question: What are the risk factors of newborn birth weight? Does gestational weight gain and prepregnancy body mass index affect childhood weight?
Finding: Excess maternal weight gain increases the risk of overweight/obesity, newborn birth weight, and child body mass index at 4–6 years.
Meaning: Maternal weight control before and during pregnancy should be well controlled.
Editorial
General Pediatrics
Is it time to add point-of-care ultrasound education to pediatric residency curriculum?   (636 times)
Shin Ae Yoon
Clin Exp Pediatr. 2022;65(1):33-34.   Published online October 12, 2021
Growing point-of-care ultrasound (POCUS) use in pediatric patients has led to the need for POCUS education for pediatric residents. Recent experimental studies have suggested that POCUS education improves self-rated POCUS confidence and comfort in pediatric resident training. Considering the effective and sustainable POCUS education curriculum in pediatric resident training, simulation-based education would be a solution.
Original Article
Cardiology
Vasovagal syncope with mild versus moderate autonomic dysfunction: a 13-year single-center experience   (632 times)
Han Eoul Lee, Dong Won Lee
Clin Exp Pediatr. 2022;65(1):47-52.   Published online June 1, 2021
Question: It is well known that autonomic dysfunction contributes to vasovagal syncope (VVS). Does the degree of autonomic dysfunction contribute to clinical manifestations, diagnostic methods, treatment, and prognosis?
Finding: The clinical manifestations, diagnostic methods, treatment, and prognosis differ between patients with mild and moderate degrees of autonomic dysfunction.
Meaning: VVS is caused by autonomic dysfunction, but autonomic dysfunction severity need not be classified.
Editorial
Endocrinology
Ambient air pollution and pediatric diabetes   (624 times)
Jae Hyun Kim
Clin Exp Pediatr. 2021;64(10):523-534.   Published online March 12, 2021
· Epidemiological studies have shown that ambient air pollution is associated with diabetes mellitus in children and adults.
· The mechanism of ambient air pollution causing diabetes mellitus is unclear.
· A study of the association between diabetes and air pollution in Korean pediatric populations is required.
Nephrology (Genitourinary)
Pulmonary thromboembolism: a rare but life-threatening complication of nephrotic syndrome   (622 times)
Heeyeon Cho
Clin Exp Pediatr. 2021;64(8):406-407.   Published online February 4, 2021
Pulmonary thromboembolism (PTE) is often diagnosed in children with nephrotic syndrome. Massive PTE can cause hemodynamic instability, right ventricular failure, and circulatory collapse. Extracorporeal membrane oxygenation can be used for massive PTE as a method of hemodynamic support and adjunct to surgical embolectomy.
Original Article
Neonatology (Perinatology)
The protective effect of CXC chemokine receptor 2 antagonist on experimental bronchopulmonary dysplasia induced by postnatal systemic inflammation   (619 times)
Seung Hyun Lee, Chang Won Choi
Clin Exp Pediatr. 2021;64(1):37-43.   Published online July 15, 2020
Question: Can CXC chemokine receptor 2 (CXCR2) antagonist preserve alveolarization by attenuating the inflammation induced by systemic lipopolysaccharide (LPS) administration in a rat model of bronchopulmonary dysplasia (BPD)?
Finding: CXCR2 antagonist significantly decreased neutrophil counts in bronchoalveolar lavage fluid and peripheral blood induced by systemic LPS administration and restored alveolarization in newborn rats.
Meaning: CXCR2 antagonist protected the lungs from the inflammation in a rat model of BPD.
Editorial
Allergy
Targeting eosinophils: another strategy for asthma treatment   (618 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.
Nephrology (Genitourinary)
Obesity and chronic kidney disease: what should pediatric nephrologists know?   (617 times)
Jung Won Lee
Clin Exp Pediatr. 2021;64(10):521-522.   Published online June 1, 2021
• Obesity is not only a comorbidity of hypertension, it may be a riskfactorfor chronickidneydisease.
• Renal impairment associated with obesity is believed to start early in childhood and continue into adulthood, implying a higher risk of adverse cardiovascular events.
• The identification of kidney injury, implementation of preventive strategies, and prompt treatment are essential to improving clinical outcomes in obese children with early kidney disease.
Gastroenterology
Does smartphone overuse affect functional gastrointestinal disorders?   (612 times)
Jee Hyun Lee
Clin Exp Pediatr. 2021;64(9):471-472.   Published online December 28, 2020
Functional gastrointestinal disorders are common disorders characterized by persistent and recurrent gastrointestinal symptoms. Pathophysiological mechanisms have been suggested, including intestinal microbiota, altered intestinal permeability and motility, dietary effects, sensory abnormalities, and brain-gut dysregulation. Lifestyle factors such as diet, sleep, affect, and physical activity might function as moderators.
Infection
Babies born to mothers positive for SARS-CoV-2 – Are they in danger?   (611 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.
Letter to the Editor
Critical Care Medicine
Role of serum bilirubin-to-albumin ratio as a prognostic index in critically ill children   (610 times)
You Min Kang, Ga Eun Kim, Mireu Park, Jong Deok Kim, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Son, Soo Yeon Kim
Clin Exp Pediatr. 2023;66(2):85-87.   Published online December 5, 2022
Clinical note
Nephrology (Genitourinary)
Extracorporeal membrane oxygenation with systemic heparinization as a rescue therapy for acute life-threatening pulmonary thromboembolism complicating nephrotic syndrome   (608 times)
Kyusang You, So Mi Kim, Dongmin Kim, Kyoungmin Ryu, Mee Jeong Lee
Clin Exp Pediatr. 2021;64(8):430-432.   Published online November 16, 2020
Question: How would you treat acute life-threatening pulmonary thromboembolism occurring in nephrotic patients?
Finding: A 16-year-old woman with minimal change-associated nephrotic syndrome presented with cardiac arrest caused by an acute bilateral pulmonary thromboembolism. Her hemodynamics stabilized with resolution of thrombi while on venoarterial extracorporeal membrane oxygenation (ECMO) and systemic heparinization.
Meaning: In selected cases, ECMO with systemic heparinization may rescue patients from acute life-threatening pulmonary thromboembolism even without reperfusion therapy.
Letter to the Editor
Neonatology (Perinatology)
Role of neutrophil CD11b expression in diagnosis of earlyonset neonatal sepsis in full-term infant   (600 times)
Safaa ELMeneza, Walaa Mohamed, Iman Elbagoury, Karima Bahagat
Clin Exp Pediatr. 2021;64(1):44-45.   Published online April 14, 2020
Question: Can CD11b detect sepsis in full-term infants with suspected sepsis?
Finding: The percentage of neutrophils expressing CD11b was significantly upregulated in the sepsis and suspected sepsis groups versus the control group.
Meaning: CD11b is a sensitive marker for sepsis and suspected sepsis in full-term neonates and it may be added to sepsis markers. This information would allow the neonatologist to confidently discontinue antibiotic use as long as the neonate is clinically stable.
Telemedicine as progressive treatment approach for neonatal jaundice due to the coronavirus disease 2019 pandemic   (598 times)
Sukanya Sudhir Joshi, Bithiah Roy Benroy, Isabell Nelson Lawrence, Thanuja Jayasri Suresh
Clin Exp Pediatr. 2022;65(5):269-271.   Published online February 7, 2022
Question: How can the management of neonatal jaundice (NJ) be enhanced through telemedicine?
Finding: Teleconsultations, drive-through testing, and the use of an application to assess neonatal jaundice at home are being successfully used, but they must be further researched before being implemented on a larger scale.
Meaning: Recent technology allows for the treatment of NJ at home with an application that helps reduce hospital burden.
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