Clinical and Experimental Pediatrics

Original Article

Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial

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 Liu

Background: Respiratory, gastrointestinal, and allergic diseases can significantly affect children’s physical and mental health and quality of life.
Purpose: This study aimed to assess the safety of Bifidobacterium animalis subsp. lactis BLa80, its preventive effects on morbidities related to respiratory, gastrointestinal, and allergic diseases, and its impact on the gut microbiome of children during the study period. Methods: Healthy children aged 0–3...

DOI: https://doi.org/10.3345/cep.2025.01256 [Accepted]

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Associations of routine breakfast and napping habits with early adiposity rebound by age 3 years: a populationbased cohort study in Japan

Toshifumi Yodoshi

Background: Early adiposity rebound (AR) is a key predictor of later obesity and metabolic risk, yet modifiable factors related to early AR remain understudied in large populations.
Purpose: To quantify the prevalence of early AR at age 3 years and identify modifiable correlates in a population‑based cohort of Japanese preschool children. Methods: We retrospectively analyzed health-check records for 74,466 children who attended both 1.5- and 3-year examinations (2014–2019). Body mass...

DOI: https://doi.org/10.3345/cep.2025.01998 [Accepted]

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Maternal sleep disorders during pregnancy and subsequent risk of allergic diseases in Japanese children: the TMM BirThree Cohort Study

Ami Uematsu, Masatsugu Orui, Mami Ishikuro, Keiko Murakami, Aoi Noda, Genki Shinoda, Taku Obara, Shinichi Kuriyama

Background: Associations have been suggested between prenatal exposure and allergic diseases in children as well as between respiratory allergies and maternal sleep disorders during pregnancy.
Purpose: This study aimed to examine the association between maternal sleep disorders during pregnancy and allergic diseases, including respiratory, skin, and ocular allergies, in their children. Methods: This study was based on the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. Sleep disorders during...

DOI: https://doi.org/10.3345/cep.2025.01165 [Accepted]

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Review Article

Exploring nutritional screening tools for hospitalized children: a narrative review

Pankaj Soni, Amit Agrawal, Gaurav Jadon

Malnutrition is common among hospitalized children, especially those who are critically ill. Routine measures, such as anthropometric measurements, body composition, and nutritional assessment, comprise the basics of monitoring. This review discusses the adequacy of nutritional screening tools (NSTs) such as the SGNA (Subjective Global Nutritional Assessment), PYMS (Pediatric Yorkhill Malnutrition Score), STAMP (Screening Tool for the Assessment of Malnutrition in Paediatrics), and STRONGkids (Screening Tool for Risk of Nutritional Status...

DOI: https://doi.org/10.3345/cep.2025.00633 [Accepted]

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Original Article

High-dose methylprednisolone and tocilizumab improve survival of patients with high-risk pediatric acute necrotizing encephalopathy

Chaonan Fan, Fei Li, Kechun Li, Zheng Li, Yiyang Mao, Lijuan Wang, Gang Liu, Yingchao Liu, Quan Wang, Suyun Qian

Background: Acute necrotizing encephalopathy (ANE) is a rare but devastating neurological disorder in children that is typically triggered by viral infections such as influenza, sudden acute respiratory syndrome coronavirus 2, and human herpesvirus-6. ANE is characterized by cytokine storm and associated with high mortality; however, optimal immunomodulatory strategies remain undefined.
Purpose: To evaluate the effectiveness of multiple immunomodulatory strategies, including high-dose methylprednisolone (MP), plasma exchange (PLEX), and tocilizumab, at reducing short-term...

DOI: https://doi.org/10.3345/cep.2025.01431 [Accepted]

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Review Article

General Pediatrics

Bridging the gap: autism spectrum disorder in children in the United States and worldwide: a narrative review

Sandhya J. Kadam, Malika Goel

Clin Exp Pediatr. 2025;68(11):852-857. Published online October 2, 2025

The prevalence of autism is increasing worldwide. The United States has the highest numbers, likely due to the availability of better treatment options. However, global disparities exist, especially in low-resource settings in which stigma, underdiagnosis, and limited services hinder care. A coordinated international approach emphasizing early screening, inclusive policies, and culturally sensitive support systems can bridge this gap and improve the outcomes for children with autism and their families worldwide.

DOI: https://doi.org/10.3345/cep.2025.00969

Endocrinology

Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications

Hwa Young Kim, Jaehyun Kim

Clin Exp Pediatr. 2025;68(11):842-851. Published online October 2, 2025

Continuous glucose monitoring (CGM) has transformed pediatric type 1 diabetes care by facilitating tighter glycemic control, reducing hypoglycemia, and improving quality of life.
Recent advances in CGM technology and the expansion of insurance coverage in Korea have led to its broader adoption.
Emerging metrics such as time in tight range offer refined tools for individualized glycemic assessment, highlighting CGM’s evolving role in personalized pediatric diabetes management.

DOI: https://doi.org/10.3345/cep.2025.01522

Original Article

Clinical outcomes and healthcare utilization of hospitalized children with influenza versus COVID-19

David Chun-Ern Ng, Chuin-Hen Liew, Kah Kee Tan, Joanne Pereira, Muhammad Ihsan Roslan, Xiang Lin Cheng, Hui Yi Lim, Farah Nuruliayana A.Nazri, Asuwani Maran, Wan Fei Wong, Yasothai Chandran, Syaniza Shaharudin, Pon Ling Lau, Naveen Nair Gangadaran, Marlindawati Mohd Ali

Background: Influenza and coronavirus disease 2019 (COVID-19) are major causes of pediatric respiratory illness with overlapping clinical features but potentially differing impacts on healthcare utilization and outcomes.
Purpose: To compare the clinical presentations, healthcare resource utilization, and outcomes of children hospitalized with influenza and COVID-19 and address the gaps in pediatric data from Southeast Asia. Methods: This retrospective observational study included children aged ≤12 years hospitalized with laboratoryconfirmed influenza or...

DOI: https://doi.org/10.3345/cep.2025.00759 [Accepted]

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Other

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

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

Cytokine profile of Post–cardiopulmonary bypass in children

Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surassombatpattana, Pharsai prasertsan

Background: Open cardiac surgery involving cardiopulmonary bypass (CPB) triggers a systemic inflammatory response that significantly affects clinical outcomes. However, the dynamics and specific roles of cytokine release after CPB in the pediatric population remain unclear.
Purpose: To evaluate the dynamics of cytokine levels and their association with low cardiac output syndrome (LCOS)-related outcomes. Methods: A prospective observational cohort study was conducted of 32 children who underwent elective open cardiac surgery...

DOI: https://doi.org/10.3345/cep.2025.00836 [Accepted]

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Other

Role of neutrophil elastase in predicting infection among children with chemotherapy-induced febrile neutropenia

Mahmoud A. El-Hawy, Doaa M. Elian, Mai El-Sayad Abd El-Hamid, Esraa T. Allam, Mariam S. Kandeel, Asmaa A. Mahmoud

Clin Exp Pediatr. 2025;68(10):801-807. Published online June 10, 2025

Question: Can neutrophil elastase (NE) levels predict infection— the primary cause of mortality—among children with hematological malignancies and febrile neutropenia (FN)?
Finding: Elevated levels of NE were found in children with chemotherapy-induced FN and a bacterial infection.
Meaning: Increased NE levels and prolonged FN are important factors associated with mortality risk.

DOI: https://doi.org/10.3345/cep.2025.00318

Review Article

Allergy

Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study

Tae Hyeon Kim, Hyunjee Kim, Jiyeon Oh, Soeun Kim, Michael Miligkos, Dong Keon Yon, Nikolaos G Papadopoulos

Clin Exp Pediatr. 2025;68(5):329-343. Published online April 22, 2025

Web of Science 4 Crossref 5

Pediatric asthma can persist to adulthood and must be effectively managed. This review examined the prevalence of asthma among individuals younger than 20 years and revealed a decline from 1990 to 2021, higher rates in males, and a peak in children aged 5–9 years. Despite a projected continued decrease in prevalence by 2050, asthma will remain a significant health concern for children and adolescents.

DOI: https://doi.org/10.3345/cep.2025.00423

Original Article

Pulmonology

Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia

Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat

Clin Exp Pediatr. 2025;68(7):497-502. Published online April 1, 2025

Question: Postinfectious bronchiolitis obliterans (PIBO) is a chronic respiratory disease that typically develops in children after a severe respiratory infection. Bronchopulmonary dysplasia (BPD) is often comorbid in patients with PIBO.
Finding: Corticosteroid pulse therapy effectively manages PIBO with or without comorbid BPD, significantly reducing exacerbations and decreasing the daily requirement for inhaled corticosteroids.
Meaning: Therapeutic effects of corticosteroid pulses are rapid and sustained over time, in both groups.

DOI: https://doi.org/10.3345/cep.2025.00122

Hematology

Hematopoietic stem cell transplantation in pediatric patients with type VI mucopolysaccharidosis

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

Crossref 2

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.

DOI: https://doi.org/10.3345/cep.2024.02033

Gastroenterology

Somatic symptom severity during acute illnesses among children with functional gastrointestinal disorders

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

Pulmonology

Nonlinear association between neutrophil-to-lymphocyte ratio and asthma in children and adolescents in the United States: a cross-sectional study

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

Critical Care Medicine

Serum amyloid A and proadrenomedullin as early markers in critically ill children with sepsis

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

Nutrition

The Korea Infant Physical Growth Examination Survey (KIPGroS): a study protocol

Jong Woo Hahn, MinSoo Shin, Jin Gyu Lim, Yoon-Joo Kim, Ki Soo Kang, Narae Lee, Seong Hee Jeong, Mun Hui Jeong, Yeoun Joo Lee, Eui Kyung Choi, Jung Ok Shim, Jee Yoon Park, Chan-Wook Park, Joo Young Kim, Su Jin Jeong, Young Hwa Jung, Jaehyun Kim, Chang Won Choi, Ju Whi Kim, Seung Han Shin, Yun Jeong Lee, Young Ah Lee, Choong-Ho Shin, Seung-sik Hwang, Young Eun Kim, Youn Ha Kang, Kyungwon Oh, Sungha Yun, Jae Sung Ko, Jin Soo Moon

Clin Exp Pediatr. 2025;68(5):352-358. Published online February 13, 2025

The suitability of World Health Organization (WHO) growth charts for assessing the growth of children under 3 years of age in all countries remains controversial, and their applicability must be evaluated based on country-specific growth data. The Korea Infant Physical Growth Examination Survey evaluated the suitability of WHO growth charts to contribute to the next revision of growth charts in Korea.

DOI: https://doi.org/10.3345/cep.2024.00297

Original Article

Nephrology (Genitourinary)

COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus

Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn

Clin Exp Pediatr. 2025;68(6):454-462. Published online February 3, 2025

Web of Science 1 Crossref 2

Question: What is the acceptance rate for coronavirus disease 2019 vaccination among parents of children with systemic lupus erythematosus (SLE)?
Finding: One-third of parents were hesitant to vaccinate their child. Parental willingness to vaccinate themselves, older patient age, and belief in the vaccine's potency were associated with vaccine acceptance.
Meaning: These findings highlight the need for targeted interventions to improve vaccine acceptance among parents of children with SLE.

DOI: https://doi.org/10.3345/cep.2024.01340

Nutrition

Differential effects of dietary and physical activity interventions on adiposity of children with obesity

Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho

Clin Exp Pediatr. 2025;68(5):370-378. Published online February 3, 2025

Question: How do dietary intake and physical activity affect body mass index (BMI) z scores and adiposity among children with obesity?
Finding: Higher dietary protein and fiber intakes were significantly associated with a decrease in BMI z scores and adiposity among children with obesity.
Meaning: Optimizing dietary interventions by focusing on protein and fiber intakes could be an effective strategy for managing childhood obesity.

DOI: https://doi.org/10.3345/cep.2024.01347

Infection

Enteric pathogens implicated in acute infectious diarrhea among young children in resource-limited region with rapidly growing population: a hospital-based cross-sectional study

Aseel Mahmood Ibrahim Al-Mashahedah, Randa Mohammed Dhahi

Clin Exp Pediatr. 2025;68(5):379-387. Published online December 23, 2024

Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible?
Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected.
Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea.

DOI: https://doi.org/10.3345/cep.2024.01333

Nephrology (Genitourinary)

C3 glomerulopathy in children: experience at a resource-limited center

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

Neurology

Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study

Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius

Clin Exp Pediatr. 2025;68(4):303-310. Published online November 13, 2024

Question: What is the occurrence of pediatric stroke in Indonesia?
Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%).
Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims.

DOI: https://doi.org/10.3345/cep.2024.01214

Review Article

Gastroenterology

Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children

Byung-Ho Choe

Clin Exp Pediatr. 2025;68(3):185-198. Published online November 13, 2024

Crossref 1

Eosinophilic gastrointestinal disorders (EGIDs) often coexist with functional gastrointestinal disorders (FGIDs) and other IgE or non-IgE mediated GI diseases. Diagnosing EGIDs requires a high index of suspicion and a comprehensive approach to differentiate them from conditions like inflammatory bowel disease. Tests such as fecal calprotectin and biopsies aid in severe cases. Maintaining a food diary helps identify triggers for long-term elimination. Awareness and education are key to effective management.

DOI: https://doi.org/10.3345/cep.2024.01165

Value of transabdominal ultrasonography for diagnosing functional constipation in children: a systematic review and meta-analysis

Duc Long Tran, Phu Nguyen Trong Tran, Paweena Susantitaphong, Phichayut Phinyo, Palittiya Sintusek

Clin Exp Pediatr. 2025;68(2):127-135. Published online November 13, 2024

Transabdominal ultrasonography is increasingly used as a novel modality for detecting pediatric functional constipation (FC). This systematic review and metaanalysis aimed to assess the diagnostic parameters of FC including rectal diameter (RD) and anterior rectal wall thickness. A systematic search was conducted of the Ovid MEDLINE, Embase, Scopus, and PubMed databases through September 29, 2023, to identify studies comparing RD...

DOI: https://doi.org/10.3345/cep.2024.00927

Original Article

Neurology

Evaluation of pediatric migraine triggers: a single-center study

Hey-Joon Son, Joo-Ok Jin, Kon-Hee Lee

Clin Exp Pediatr. 2025;68(2):163-169. Published online November 11, 2024

Crossref 1

Question: What are the primary triggers for pediatric migraines, and how do they impact clinical management?
Finding: Common triggers for pediatric migraines include sleep disturbances, academic stress, and motion sickness, with academic stress identified as the most intense.
Meaning: Recognizing and addressing specific triggers like sleep disturbance and academic stress is crucial to effectively managing pediatric migraines with emphasis on personalized care to improve outcomes.

DOI: https://doi.org/10.3345/cep.2024.00738

Review Article

Other

Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea

Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S. Tremblay

Clin Exp Pediatr. 2025;68(1):16-29. Published online November 11, 2024

Web of Science 3 Crossref 3

· The 24-hour movement behavior paradigm provides an important framework for future pediatric health promotion efforts.
· Policy priorities should include advancing surveillance and monitoring assessments related to 24-hour movement behaviors, evaluating their implementation in school and government policies, and building preparedness for future pandemics and natural disasters, including climate change, by promoting healthy 24-hour movement behaviors.
· Future research should advocate for the promotion of 24- hour movement behaviors.

DOI: https://doi.org/10.3345/cep.2024.00178

Original Article

General Pediatrics

Nonpharmacological interventions for managing postoperative pain and anxiety in children: a randomized controlled trial

Edlin Glane Mathias, Mamatha Shivananda Pai, Vijay Kumar, Dinesh Narayanakurup, Malavika Kulkarni, Vasudeva Guddattu, Ann-Cathrine Bramhagen, Baby S Nayak, Anice George

Clin Exp Pediatr. 2024;67(12):677-685. Published online October 31, 2024

Web of Science 1 Crossref 2

Question: What is the effect of nonpharmacological interventions on postoperative pain and anxiety among children.
Finding: Nurse-provided distraction interventions reduce pain and anxiety among pediatric surgical patients.
Meaning: The findings suggest that nonpharmacological interventions provided postoperatively to children reduce their pain and anxiety levels.

DOI: https://doi.org/10.3345/cep.2023.01690

Review Article

General Pediatrics

Protecting our future: environmental hazards and children’s health in the face of environmental threats: a comprehensive overview

Jungha Lee, Hyo-Bin Kim, Hun-Jong Jung, Myunghee Chung, So Eun Park, Kon-Hee Lee, Won Seop Kim, Jin-Hwa Moon, Jung Won Lee, Jae Won Shim, Sang Soo Lee, Yunkoo Kang, Young Yoo; The Environmental Health Committee of the Korean Pediatric Society

Clin Exp Pediatr. 2024;67(11):589-598. Published online October 31, 2024

Web of Science 3 Crossref 5

· Exposure to air pollutants cause allergic and respiratory diseases as well as chronic kidney disease.
· Adequate physical activity and proper nutrition are essential for children to maintain good health.
· We must educate people about the harmful effects of noise, blue light, heavy metals and smoke.
· Government and society must actively decrease environ-mental hazards.

DOI: https://doi.org/10.3345/cep.2023.01578

Original Article

Pulmonology

Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis

Hyeri Jeong, Dawon Park, Eun Kyo Ha, Ju Hee Kim, Jeewon Shin, Hey-Sung Baek, Hyunsoo Hwang, Youn Ho Shin, Hye Mi Jee, Man Yong Han

Clin Exp Pediatr. 2024;67(11):608-618. Published online October 28, 2024

· This study analyzed 45 randomized controlled trials (5,061 participants, 13 interventions) of the comparative efficacies of treatments for acute bronchiolitis in infants.
· Inhalation therapy with epinephrine and hypertonic saline significantly reduced the length of hospital stay compared with normal saline.
· Hypertonic saline had the greatest ability to improve the clinical severity score of bronchiolitis in infants younger than 2 years of age.

DOI: https://doi.org/10.3345/cep.2023.01676

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