Clinical and Experimental Pediatrics

Correspondence and Reply

Neurobehavior

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

Ensiyeh Jenabi

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

DOI: https://doi.org/10.3345/cep.2021.01298.r2

Editorial

Infection

Importance of maintaining a high childhood vaccination rate and surveillance program against Japanese encephalitis in Korea

Su Eun Park

Clin Exp Pediatr. 2022;65(3):127-128. Published online February 16, 2022

Web of Science 2 Crossref 1

∙ Recent epidemiologic changes of Japanese encephalitis (JE) in Korea are area (rural to urban or suburban) and age shift (children to adult).
∙ Although the main factors contributing to recent epidemiologic changes of JE are not well identified, maintaining high vaccination rates of JE appear to be important in preventing of JE in all age groups.
∙ Continuous surveillance for epidemiology and seroprevalence should be carried out.

DOI: https://doi.org/10.3345/cep.2021.01557

Review Article

Neurology

Rotavirus infection-associated central nervous system complications: clinicoradiological features and potential mechanisms

Kyung Yeon Lee

Clin Exp Pediatr. 2022;65(10):483-493. Published online February 7, 2022

Web of Science 12 Crossref 12

∙ Rotavirus infection-associated central nervous system (CNS) complications are fairly common in children.
∙ Common clinicoradiological features include benign convulsions with mild gastroenteritis, acute encephalopathies/encephalitis, cerebellitis, and neonatal rotavirus-associated leukoencephalopathy.
∙ Possible mechanisms for CNS complications include direct viral invasion into the brain via several potential routes such as the blood-brain barrier and vagus nerve, and entry of various brain-damaging mediators and activated immune cells into the brain.

DOI: https://doi.org/10.3345/cep.2021.01333

Letter to the Editor

Neonatology (Perinatology)

Telemedicine as progressive treatment approach for neonatal jaundice due to the coronavirus disease 2019 pandemic

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

Web of Science 3 Crossref 3

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.

DOI: https://doi.org/10.3345/cep.2021.01235

Editorial

Allergy

Dietary restriction misconceptions and food allergy education in children with atopic dermatitis

You Hoon Jeon

Clin Exp Pediatr. 2022;65(2):83-84. Published online January 27, 2022

Web of Science 6 Crossref 5

∙ 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.

DOI: https://doi.org/10.3345/cep.2021.01634

Endocrinology

Clinical and diagnostic importance of dyslipidemia in children and adolescents during the coronavirus disease 2019 pandemic

Eun Young Kim

Clin Exp Pediatr. 2022;65(3):129-130. Published online January 14, 2022

Web of Science 2 Crossref 2

∙ Because childhood lipid concentrations continue into adulthood, early evaluation and treatment are needed, but dyslipidemia awareness is low.
∙ For the prevention and treatment of dyslipidemia in childhood and adolescence, a major risk factor for cardiovascular disease in adulthood, lifestyle modifications, appropriate exercise, and drug treatment are required.
∙ A large-scale study of the prevalence and therapeutic effects of dyslipidemia in children and adolescents in Korea is needed.

DOI: https://doi.org/10.3345/cep.2021.01851

Neurology

Cerebrospinal fluid biomarkers in various pediatric neurologic diseases

Jeongho Lee

Clin Exp Pediatr. 2022;65(2):81-82. Published online January 6, 2022

Web of Science 1 Crossref 1

Cerebrospinal fluid (CSF) has many important biomarkers that are commonly analyzed in pediatric neurologic diseases, including central nervous system infection and inflammation. Neurologic disease in pediatrics is difficult to diagnosis, there are challenges in developing CSF profiles. Some biomarkers are expected to help differential diagnosis.

DOI: https://doi.org/10.3345/cep.2021.01445

Endocrinology

Pediatric obesity: life cycle approach of pediatrician and society

Yong Hee Hong

Clin Exp Pediatr. 2022;65(1):29-30. Published online December 28, 2021

Web of Science 4 Crossref 5

• With the emerging epidemic of pediatric obesity, many endocrine comorbidities classically seen in adulthood are surfacing much earlier in life.
• Appropriate obesity counseling and education should be provided from infancy to adolescence.
• Managing pediatric obesity may require school and society involvement.

DOI: https://doi.org/10.3345/cep.2021.01536

Review Article

Neurology

Update on benign convulsions with mild gastroenteritis

Yeong Seok Lee, Ga Hee Lee, Young Se Kwon

Clin Exp Pediatr. 2022;65(10):469-475. Published online December 27, 2021

Web of Science 7 Crossref 10

∙ The main pathogen for benign convulsions with mild gastroenteritis (CwG) was previously rotavirus; however, cases associated with norovirus are increasing.
∙ CwG is characterized by clustered generalized seizures. Electroencephalography and magnetic resonance imaging show transiently abnormal findings in the acute phase that eventually normalize with progression. Its prognosis is good, and long-term treatment is unnecessary.
∙ There are many reports on the pathophysiological mechanism of CwG, which remains unclear.

DOI: https://doi.org/10.3345/cep.2021.00997

Oncology

Application of 3-dimensional printing implants for bone tumors

Jong Woong Park, Hyun Guy Kang

Clin Exp Pediatr. 2022;65(10):476-482. Published online December 23, 2021

Web of Science 14 Crossref 18

∙ The application of 3-dimensional (3D) printing in orthopedic oncology is summarized into bone and tumor modeling, patient-specific instruments (PSIs), custom-made implants, and tissue engineering.
∙ The 3D-printed customized implant is the most central application, while modeling and PSI often play adjunct roles.
∙ Short-term surgical outcomes of custom-made 3D-printed implants are promising.

DOI: https://doi.org/10.3345/cep.2021.01326

Gastroenterology

Factors influencing development of the infant microbiota: from prenatal period to early infancy

Sujin Jeong

Clin Exp Pediatr. 2022;65(9):439-447. Published online December 23, 2021

Web of Science 35 Crossref 36

∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial.
∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage.
∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life.
∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism.

DOI: https://doi.org/10.3345/cep.2021.00955

Cardiology

Diagnosis of coronary artery abnormalities in Kawasaki disease: recent guidelines and z score systems

Sung Hye Kim

Clin Exp Pediatr. 2022;65(9):430-438. Published online December 17, 2021

Web of Science 8 Crossref 10

∙ Kawasaki disease is the leading cause of acquired heart disease among children in the developed countries, and Korea has the second-highest incidence in the world.
∙ Early diagnosis and proper treatment are imperative to prevent coronary complication, and evaluation of coronary artery abnormalities is fundamental.
∙ Recent guidelines have adapted z score system for the diagnosis of coronary artery abnormalities in Kawasaki disease.
∙ Applying z score in diagnosis of coronary abnormalities has better correlation with clinical outcomes than absolute cutoff values.
∙ Calculated z scores could be different according to the z score formula, which might influence the treatment plan.

DOI: https://doi.org/10.3345/cep.2021.01459

Neurology

Recent trends of healthcare information and communication technologies in pediatrics: a systematic review

Se young Jung, Keehyuck Lee, Hee Hwang

Clin Exp Pediatr. 2022;65(6):291-299. Published online December 15, 2021

Web of Science 13 Crossref 9

· The innovation of healthcare information communication technology (ICT) was accelerated with the adoption of electronic health records (EHRs).
· Telemedicine currently has no technical barriers.
· EHRs and personal health records are being connected, and mobile/wearable technologies are being integrated into them.
· Conventional rule-based clinical decision support systems have already been implemented and used in EHRs and PHRs. Artificial intelligence/machine learning improves precision and accuracy.

DOI: https://doi.org/10.3345/cep.2020.01333

Neonatology (Perinatology)

Breastfeeding and vitamin D

Ju Sun Heo, Young Min Ahn, Ai-Rhan Ellen Kim, Son Moon Shin; for the Korean Society of Breastfeeding Medicine

Clin Exp Pediatr. 2022;65(9):418-429. Published online December 14, 2021

Web of Science 6 Crossref 8

∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes.
∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%.
∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants.
∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life.
∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring.

DOI: https://doi.org/10.3345/cep.2021.00444

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

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

Web of Science 13 Crossref 13

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

Neurology

Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the National Health Screening Program for Infants and Children database

Og Hyang Kim, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, Yun Hye Jo, Seongyeong Rhie, Man Yong Han, Kyu Young Chae

Clin Exp Pediatr. 2022;65(6):312-319. Published online December 9, 2021

Web of Science 9 Crossref 12

Question: What comorbidities are increased in children with congenital muscular torticollis (CMT)? Are there differences in the neurodevelopmental outcomes of children with CMT who received physical therapy versus those who did not?
Finding: The risk of congenital musculoskeletal deformities is increased in CMT. Children who did not receive physical therapy were at greater risk of neurodevelopmental delay.
Meaning: In CMT, musculoskeletal comorbidities should be identified and active early treatment provided.

DOI: https://doi.org/10.3345/cep.2021.01417

Review Article

General Pediatrics

A new perspective on cholesterol in pediatric health: association of vitamin D metabolism, respiratory diseases, and mental health problems

Jeana Hong

Clin Exp Pediatr. 2022;65(2):65-72. Published online December 9, 2021

Web of Science 3 Crossref 1

∙ Pediatric dyslipidemia is associated with several health problems besides cardiovascular diseases.
∙ There is a direct association between pediatric dyslipidemia and low serum vitamin D levels, asthma, and mental health problems regardless of body mass index.
∙ More large-scale nationally representative studies are needed to establish the appropriate cutoff points for the definition of dyslipidemia that is a prerequisite for further epidemiological studies in the Korean pediatric population.

DOI: https://doi.org/10.3345/cep.2020.00934

Original Article

Cardiology

Early myocardial functional abnormalities in primary dyslipidemia: clinical and echocardiographic observations in young children from a highly consanguineous population

Nehal M. El-koofy, Aya M. Fattouh, Areef Ramadan, Mohamed A. Elmonem, Dina H. Hamed

Clin Exp Pediatr. 2022;65(8):410-416. Published online December 8, 2021

Web of Science 2 Crossref 3

In children with primary dyslipidemia, functional myocardial abnormalities can occur at young age, including diastolic functional impairment of both ventricles and narrowing of the aortic valve and the sinus of Valsalva. Echocardiographic evaluations of high-risk children may be as important as biochemical evaluations.

DOI: https://doi.org/10.3345/cep.2021.00598

Clinical note

General Pediatrics

Diabetic ketoacidosis in children induced by coronavirus disease 2019 (COVID-19) diabetic ketoacidosis post-COVID-19 in children

Neha Thakur, Narendra Rai

Clin Exp Pediatr. 2022;65(4):209-210. Published online November 30, 2021

Web of Science 3 Crossref 4

DOI: https://doi.org/10.3345/cep.2021.00941

Review Article

Infection

Epidemiological changes in infectious diseases during the coronavirus disease 2019 pandemic in Korea: a systematic review

Jong Gyun Ahn

Clin Exp Pediatr. 2022;65(4):167-171. Published online November 30, 2021

Web of Science 15 Crossref 14

· Nonpharmaceutical interventions (NPIs) have had a major impact on the epidemiology of various infectious diseases in Korea.
· Respiratory diseases and gastrointestinal viral diseases were significantly reduced during the NPI period.
· The decrease in Kawasaki disease after the introduction of NPI is an unintended result.
· Infectious diseases that decreased during NPI use may re-emerge.
· We must continuously monitor the epidemiology of various infectious diseases during the coronavirus era

DOI: https://doi.org/10.3345/cep.2021.01515

Endocrinology

Pediatric hypertension based on Japanese Society of Hypertension Guidelines (JSH 2019) with actual school blood pressure screening data in Japan

Toru Kikuchi

Clin Exp Pediatr. 2022;65(6):283-290. Published online November 26, 2021

Web of Science 5 Crossref 6

The prevalence of Japanese pediatric hypertension is 0.9% based on proper measurement protocols. Hypertensive children tend to be hypertensive adults. Pediatric essential hypertension is characterized by an absence of symptoms, obesity, a family history of hypertension, and a low birth weight. The most common causes of pediatric secondary hypertension are renal parenchymal and renovascular diseases. Important factors controlling pediatric hypertension include healthy lifestyle modifications and pharmacotherapy.

DOI: https://doi.org/10.3345/cep.2021.00920

Neurology

Big data analysis and artificial intelligence in epilepsy – common data model analysis and machine learning-based seizure detection and forecasting

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

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

Web of Science 9 Crossref 10

· 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

Other

Knowledge-guided artificial intelligence technologies for decoding complex multiomics interactions in cells

Dohoon Lee, Sun Kim

Clin Exp Pediatr. 2022;65(5):239-249. Published online November 26, 2021

Web of Science 5 Crossref 5

· The need for data-driven modeling of multiomics interactions was recently highlighted.
· Many artificial intelligence-driven models have been developed, but only a few have incorporated biological domain knowledge within model architectures or training procedures.
· Here we provide a comprehensive review of deep learning models to decipher complex multiomics interactions regarding the biological guidance imposed upon them to facilitate further development of biological knowledge-guided deep learning models.

DOI: https://doi.org/10.3345/cep.2021.01438

Letter to the Editor

Oncology

Retrospective review of severe acute respiratory syndrome coronavirus-2 infection in children with acute leukemia from a tertiary care hospital in Northern India

Suhail Chhabra, Aditya Dabas, Richa Mittal, Neha Goel, Ritabrata Roy Chowdhary, Satyendra Batra, Amitabh Singh, Rani Gera

Clin Exp Pediatr. 2022;65(3):150-151. Published online November 26, 2021

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2021.01158

Review Article

Infection

Etiological and pathophysiological enigmas of severe coronavirus disease 2019, multisystem inflammatory syndrome in children, and Kawasaki disease

Jung-Woo Rhim, Jin-Han Kang, Kyung-Yil Lee

Clin Exp Pediatr. 2022;65(4):153-166. Published online November 23, 2021

Web of Science 20 Crossref 22

· Severe cases of coronavirus disease, Kawasaki disease (KD), and multisystem inflammatory syndrome in children (MIS-C) share similar findings: a protracted clinical course, multiorgan involvement, and similar activated biomarkers.
· Here we propose etiological agents in KD and MIS-C as species in the microbiota and introduce a common pathogenesis through the protein-homeostasis-system hypothesis.
· Early proper dose of corticosteroids and/or intravenous immunoglobulin may help to reduce morbidity and mortality in these diseases.

DOI: https://doi.org/10.3345/cep.2021.01270

Original Article

Developmental and Behavioral Medicine

Effectiveness of obesity interventions among South Korean children and adolescents and importance of the type of intervention component: a meta-analysis

Siyoung Choe, Jaesin Sa, Jean-Philippe Chaput, Deokjin Kim

Clin Exp Pediatr. 2022;65(2):98-107. Published online November 23, 2021

Question: What is the overall effect of obesity interventions among Korean children and what affects their effectiveness?
Finding: Interventions were strongly favored over controls. Interventions including at least one physical activity component were significantly better than those that did not. Sex, age, baseline weight category, intervention duration, and the number of intervention components were not significant.
Meaning: Future obesity interventions for Korean children must seek to include physical activity components.

DOI: https://doi.org/10.3345/cep.2021.00409

General Pediatrics

Effect of 2–6 weeks of systemic steroids on bone mineral density in children

Athira Kuniyil, Somdipa Pal, Namrita Sachdev, Tribhuvan Pal Yadav

Clin Exp Pediatr. 2022;65(5):254-261. Published online November 18, 2021

Web of Science 3 Crossref 3

Question: Does steroid use for 2–6 weeks in children affect bone mineral content (BMC) or density (BMD)?
Finding: Steroid use for 2–6 weeks significantly decreased BMC and BMD of the whole body, total body less the head, lumbar spine, and distal radius. A significant negative correlation was observed among BMD, duration, and cumulative dose.
Meaning: Steroid use for 2–6 weeks in children negatively affected BMC and BMD.

DOI: https://doi.org/10.3345/cep.2021.00045

Endocrinology

Effects of probiotics combined with dietary and lifestyle modification on clinical, biochemical, and radiological parameters in obese children with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis: a randomized clinical trial

Thushara Rodrigo, Samaranayake Dulani, Sumudu Nimali Seneviratne, Arjuna P. De Silva, Jerad Fernando, H. Janaka De Silva, Jayasekera , V. Pujitha Wickramasinghe

Clin Exp Pediatr. 2022;65(6):304-311. Published online November 11, 2021

Web of Science 23 Crossref 25

Question: Could probiotics be used as a therapeutic modality in nonalcoholic fatty liver disease/nonalcoholic steatohepatitis?
Finding: There seem no added advantages over lifestyle modifications compared to Probiotics.
Meaning: There does not seem to be an advantage of probiotics over lifestyle modifications in improving obesity-associated metabolic derangement in children.

DOI: https://doi.org/10.3345/cep.2021.00787

Review Article

Neurobehavior

Psychological aspects in children and parents of children with chronic kidney disease and their families

Alemsungla Aier, Priya Pais, Vijaya Raman

Clin Exp Pediatr. 2022;65(5):222-229. Published online November 10, 2021

Web of Science 16 Crossref 15

· Childhood chronic kidney disease (CKD) is complex and requires lifetime medical treatment.
· Children with CKD are at risk for emotional, behavioral, social, and academic difficulties that significantly affect their quality of life.
· Caring for children with CKD is stressful for families.
· These unique challenges are crucial and can negatively impact treatment outcomes.
· Awareness of and addressing these evolving psychosocial issues can foster their developing needs.

DOI: https://doi.org/10.3345/cep.2021.01004

Original Article

Other

Risk factors and screening timing for developmental dysplasia of the hip in preterm infants

Ga Won Jeon, Hye Jung Choo, Yong Uk Kwon

Clin Exp Pediatr. 2022;65(5):262-268. Published online November 5, 2021

Web of Science 11 Crossref 12

Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants?
Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants.
Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants.

DOI: https://doi.org/10.3345/cep.2021.01074

Cited By 28	Neurodevelopmental outcomes of preterm infants
Cited By 27	Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Cited By 23	Gut microbiota affects brain development and behavior
Cited By 23	Association of gut microbiota with obesity in children and adolescents
Cited By 21	Nonalcoholic fatty liver disease and insulin resistance in children

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