Clinical and Experimental Pediatrics

Review Article

Cardiology

Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections

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)

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

Web of Science 2 Crossref 3

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

Original Article

Hematology

Effect of cyclic pamidronate administration on osteoporosis in children with β-thalassemia major: a single-center study

Mahmoud A. El-Hawy, Nagwan Y. Saleh

Clin Exp Pediatr. 2022;65(8):405-409. Published online June 7, 2022

Web of Science 2 Crossref 3

Question: What is the effect of cyclic pamidronate administration on osteoporosis in children with β-thalassemia major?
Finding: The dual-energy x-ray absorptiometry scan findings of children with β-thalassemia major and osteoporosis were improved after pamidronate administration.
Meaning: Cyclic pamidronate effectively treated osteoporosis in children with β-thalassemia major.

DOI: https://doi.org/10.3345/cep.2019.00535

Review Article

Other

Epidemiology of pediatric fractures before versus during the coronavirus disease 2019 pandemic

Chi Hoon Oh, Siyeong Yoon, Kyung Rae Ko, Young Woo Kwon, Kyeong Mi Kim, Hyun Seo Park, Hogyeong Kang, Inseok Jang, Soonchul Lee

Clin Exp Pediatr. 2022;65(7):330-336. Published online June 3, 2022

Web of Science 4 Crossref 5

∙ The novel coronavirus disease 2019 (COVID-19) was first reported in December 2019 as a cluster outbreak in Wuhan, since then, national lockdowns have included school closures, stay-at-home orders.
∙ The characteristics of adolescent fractures were often related to physical activity such as sports-related injury.
∙ During the COVID-19 pandemic, both in the East and the West, the incidence of fractures in children and adolescents is showing a decreasing trend worldwide.
∙ Fractures in children and adolescents were significantly reduced in the proportion of relatively low-energy damage, and the incidence of fractures in adolescents with greater activity compared to children was reduced.
∙ If COVID-19 pandemic ends, normal academic and sports activities increase due to the easing of lockdown policies, the number of trauma patients related to increased activity may increase rapidly, and clinics should prepare for this change.

DOI: https://doi.org/10.3345/cep.2021.01767

Neurobehavior

Jeopardized mental health of children and adolescents in coronavirus disease 2019 pandemic

Bohyun Jin, Sohee Lee, Un Sun Chung

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

Web of Science 10 Crossref 10

∙ 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

Nephrology (Genitourinary)

Neonatal hypertension: concerns within and beyond the neonatal intensive care unit

Kathleen Altemose, Janis M. Dionne

Clin Exp Pediatr. 2022;65(8):367-376. Published online May 30, 2022

Web of Science 8 Crossref 9

Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course.

DOI: https://doi.org/10.3345/cep.2022.00486

Original Article

Oncology

Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand

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

Other

Plastic bottle feeding produces changes in biochemical parameters in human infants – A pilot study

Mahendra K. Pant, Abul. H. Ahmad, Manisha Naithani, Jayanti Pant

Clin Exp Pediatr. 2022;65(9):459-465. Published online May 19, 2022

Web of Science 3 Crossref 5

Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants?
Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding.
Meaning: Plastic bottles feeding alters bodily functions in infants.

DOI: https://doi.org/10.3345/cep.2022.00234

Infection

Role of lung ultrasound patterns in monitoring coronavirus disease 2019 pneumonia and acute respiratory distress syndrome in children

Satyabrata Roychowdhoury, Subhajit Bhakta, Manas Kumar Mahapatra, Saptarshi Ghosh, Sayantika Saha, Mithun Chandra Konar, Mihir Sarkar, Mousumi Nandi

Clin Exp Pediatr. 2022;65(7):358-366. Published online May 13, 2022

Web of Science 4 Crossref 3

Question: Potential role of patterns of lung ultrasonography (US) in monitoring changes in mechanically ventilated patients with coronavirus disease 2019 (COVID-19) pneumonia.
Finding: Interstitial syndrome, an irregular pleural line, and peripheral microconsolidation were the most prevalent findings. Changes in lung aeration after mechanical ventilation corelated with improved oxygenation. A fall in lung ultrasound reaeration score ≤ 5 may predict successful weaning.
Meaning: Lung US is gaining wider utility for monitoring COVID-19 pneumonia.

DOI: https://doi.org/10.3345/cep.2021.01655

Editorial

Other

Three-dimensional printing technolgy in orthopedic oncology

Yongsung Kim

Clin Exp Pediatr. 2022;65(10):496-497. Published online May 11, 2022

Web of Science 1 Crossref 2

Orthopedic oncology is one of the most active fields in applying 3-dimensional printing technology from preoperative planning to intraoperative procedures such as accurate resection of tumors and reconstruction of huge bone defects.

DOI: https://doi.org/10.3345/cep.2022.00080

Neurology

Increasing our understanding of rotavirus-induced central nervous system manifestations

Jon Soo Kim

Clin Exp Pediatr. 2022;65(11):536-537. Published online May 6, 2022

Web of Science 3 Crossref 3

· Diverse clinicoradiological features of central nervous system (CNS) complications in rotavirus infection can be identified with the rapid and wide use of various brain magnetic resonance imaging protocols.
· An increased understanding of the various pathophysiological mechanisms of rotavirus-induced CNS manifestations will enable precise management in the future.

DOI: https://doi.org/10.3345/cep.2022.00395

Pulmonology

Influence of coronavirus disease 2019 pandemic on respiratory health in children

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

Nutrition

Human milk oligosaccharides as immunonutrition key in early life

Jung Ok Shim

Clin Exp Pediatr. 2022;65(7):344-345. Published online May 3, 2022

Web of Science 2 Crossref 3

· Human milk is a major source of immunonutrients for neonates and infants. Human milk oligosaccharides (HMOs) act as prebiotics and promote the growth of commensal bacteria.
· HMOs inhibit microorganism adhesion to the gut mucosa through interactions with the commensal microbiome and improve gut barrier function by increasing short-chain fatty acid mediated by bifidobacteria and immunomodulation.
· Several randomized controlled trials recently reported on HMOs.

DOI: https://doi.org/10.3345/cep.2021.00990

Endocrinology

Low bone mineral density can occur in children after shortterm systemic glucocorticoid treatment

Moon Bae Ahn

Clin Exp Pediatr. 2022;65(6):300-301. Published online April 27, 2022

Osteoporosis diagnosed in children with chronic diseases is a major endocrine complication triggered by the disease itself or its treatment. Although age upon starting osteotoxic agents and the their duration of use are vital contributors, spontaneous recovery of bone mass following treatment completion is a privilege of this specific age group. For any patients short-term glucocorticoid therapy, bone health screening is the next step.

DOI: https://doi.org/10.3345/cep.2021.01599

Review Article

Allergy

Diagnosis and management of asthma in infants and preschoolers

Hai Lee Chung

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

Web of Science 9 Crossref 11

· 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

Editorial

Neonatology (Perinatology)

Factors to consider before implementing telemedicine protocols to manage neonatal jaundice

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)

Neonatal seizures: stepping outside the comfort zone

Menna Hashish, Mohamed Reda Bassiouny

Clin Exp Pediatr. 2022;65(11):521-528. Published online April 4, 2022

Web of Science 2 Crossref 3

· Use conventional and amplitude-integrated electroencephalography to confirm clinical seizures and screen high-risk newborns.
· Select an explicit clear elective event to be treated with less toxic and more effective antiepileptics.

DOI: https://doi.org/10.3345/cep.2022.00115

Neurology

Neonatal seizures: diagnostic updates based on new definition and classification

Eun-Hee Kim, Jeongmin Shin, Byoung Kook Lee

Clin Exp Pediatr. 2022;65(8):387-397. Published online April 4, 2022

Web of Science 9 Crossref 13

· Neonatal seizures are often electrographic-only seizures without clinical signs; therefore, the identification of electrical seizure activity on electroencephalography is the gold standard for diagnosis.
· Clinical signs of neonatal seizures are divided into motor or nonmotor seizures, and motor seizures are mostly focal or multifocal.
· Most neonatal seizures are caused by acute symptomatic etiologies, but in cases of intractable seizures, structural, genetic, or metabolic etiologies should be investigated.

DOI: https://doi.org/10.3345/cep.2021.01361

Editorial

Endocrinology

Is type 1 diabetes related to coronavirus disease 2019 in children?

Minsun Kim

Clin Exp Pediatr. 2022;65(5):252-253. Published online March 29, 2022

Web of Science 1 Crossref 1

· Evidence shows that patients with type 1 diabetes have been severely affected by coronavirus disease 2019 (COVID-19) in various ways.
· Although there is no reliable evidence that COVID-19 worsens or induces diabetes, it can impair β-cell insulin secretion and glucose control by inducing inflammation and cytokine production.
· A study is needed of the short- and long-term relationship between diabetes and COVID-19 in the Korean pediatric population.

DOI: https://doi.org/10.3345/cep.2021.01760

Cardiology

Coronavirus disease 2019 and mRNA vaccines: what’s next – miRNA?

Joon Kee Lee, Heon-Seok Han

Clin Exp Pediatr. 2022;65(6):302-303. Published online March 28, 2022

Web of Science 3 Crossref 1

MicroRNAs (miRNAs) are small single-stranded noncoding RNA molecules that function in RNA silencing and the posttranscriptional regulation of gene expression. The potential role of miRNAs as biomarkers of myocarditis is promising, and miRNAs are expected to be utilized in various clinical fields in the future.

DOI: https://doi.org/10.3345/cep.2022.00283

Infection

Effects of nonpharmaceutical interventions for coronavirus disease 2019

Jae Hong Choi

Clin Exp Pediatr. 2022;65(5):250-251. Published online March 22, 2022

Web of Science 1 Crossref 1

∙ Nonpharmaceutical interventions (NPIs) have decreased the incidence of various infectious diseases, including coronavirus disease 2019 (COVID-19).
∙ During the 2-year COVID-19 pandemic, NPIs changed patients’ daily lives, and the impact on mental health was notable.
∙ The effects of NPIs were evaluated in detail, considering both infections and mental health.

DOI: https://doi.org/10.3345/cep.2021.01830

Cardiology

Characteristics of z score systems for diagnosing coronary abnormalities in Kawasaki disease

Gyeong-Hee Yoo

Clin Exp Pediatr. 2022;65(9):448-449. Published online March 14, 2022

Web of Science 2 Crossref 2

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

Neonatology (Perinatology)

Ideal timing for aggressive screening to detect developmental dysplasia of the hip in term and preterm infants

Won-Ho Hahn

Clin Exp Pediatr. 2022;65(7):346-347. Published online March 14, 2022

The risk factors and pathogenesis of developmental dysplasia of the hip (DDH) are unclear. Moreover, no universal screening method can entirely eliminate the risk of DDH. However, its incidence is significant and its early detection is critical for improving patient prognosis. Although the ideal evaluation time and risk factors, especially for premature infants, are unclear, the necessity for DDH screening programs for term and preterm infants is emerging.

DOI: https://doi.org/10.3345/cep.2021.01669

Letter to the Editor

Infection

Changes in epidemiology of parainfluenza virus and respiratory syncytial virus infection during coronavirus disease 2019 pandemic in Korea

Kyung-Ran Kim, Hwanhee Park, Doo Ri Kim, Yae-Jean Kim

Clin Exp Pediatr. 2022;65(6):320-321. Published online March 10, 2022

Web of Science 5 Crossref 4

Question: How the epidemiology of other childhood respiratory viruses has changed during coronavirus disease 2019 (COVID-19) in Korea?
Finding: Parainfluenza virus (PIV) typically circulated in the spring, and respiratory syncytial virus (RSV) epidemic started in autumn in Korea before COVID-19 pandemic. PIV and RSV seasons disappeared in 2020 and came back in 2021 with atypical seasonality. PIV season was changed from spring to autumn, and the beginning of RSV season was slightly delayed from autumn to early winter in 2021.
Meaning: Circulation of PIV and RSV was changed to unusual seasons and patterns during COVID-19 pandemic period.

DOI: https://doi.org/10.3345/cep.2021.01823

Editorial

Cardiology

Early echocardiographic screening for subclinical myocardial dysfunction in children and adolescents with dyslipidemia: why and when?

Hyun Gyung Lee, Hwa Jin Cho

Clin Exp Pediatr. 2022;65(8):398-400. Published online March 7, 2022

Dyslipidemia contributes to early atherosclerosis, premature cardiovascular disease, and subclinical ventricular dysfunction in children. This paper highlights the need for echocardiographic evaluation for impaired diastolic function of both ventricles and narrowing of the aortic valve and sinus of Valsalva. Therefore, early echocardiographic screening of children with primary hyperlipidemia should be considered.

DOI: https://doi.org/10.3345/cep.2022.00031

Review Article

Cardiology

Implication of microRNA as a potential biomarker of myocarditis

Jin-Hee Oh, Gi Beom Kim, Heeyoung Seok

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

Web of Science 9 Crossref 7

· 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

General Pediatrics

Motor performance of children with attention deficit hyperactivity disorder: focus on the Bruininks-Oseretsky Test of Motor Proficiency

Khushboo Prashant Adhvaryu, Suruliraj Karthikbabu, Pratiksha Tilak Rao

Clin Exp Pediatr. 2022;65(11):512-520. Published online February 17, 2022

Web of Science 8 Crossref 8

· Children with attention deficit hyperactivity disorder (ADHD) tend to have impaired motor performance that may affect their growth and development.
· Although widely used among children with developmental disorders, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) is used sparsely among children with ADHD.
· Assessment by the BOTMP increases our understanding of the motor repertoire of children with ADHD.
· Wider usage of the BOTMP will enable more comprehensive planning of rehabilitation goals to enhance the motor abilities of children with ADHD.

DOI: https://doi.org/10.3345/cep.2021.00962

Gastroenterology

Clinical importance of immunonutrition in infants: a review of the recent literature

Ji Sook Park

Clin Exp Pediatr. 2022;65(7):337-343. Published online February 17, 2022

Web of Science 3 Crossref 4

Nutrients are important in the developing immune system. Human milk supplies diverse bioactives to prevent acute infection or chronic inflammation. Immunoglobulins, lactoferrin, and glutamine in human milk decrease gastrointestinal and respiratory infection. Human milk oligosaccharides promote the growth of intestinal microbiota, the gut barrier, and antimicrobial or antiviral activity. Micronutrients act as anti-inflammatory immunonutrients, too. However, the toxicity of some nutrients from an overdose should be considered.

DOI: https://doi.org/10.3345/cep.2021.00570

Letter to the Editor

Other

Changes in air pollution and childhood respiratory viral infections in Korea post-COVID-19 outbreak

Hyung Kyu Park, Jung Yeon Shim

Clin Exp Pediatr. 2022;65(4):211-213. Published online February 17, 2022

Web of Science 2 Crossref 3

DOI: https://doi.org/10.3345/cep.2021.01585

Correspondence and Reply

Neurobehavior

Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis

Hadith Rastad, Mahnaz Seifi Alan

Clin Exp Pediatr. 2022;65(3):152-152. Published online February 17, 2022

DOI: https://doi.org/10.3345/cep.2021.01298.r1

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