Clinical and Experimental Pediatrics

Review Article

Infection

Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia

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.

DOI: https://doi.org/10.3345/cep.2020.01305

Original article

Infection

The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis

Behnam Abedi, Mehran Akbari, Sahar KhodaShenas, Alireza Tabibzadeh, Ali Abedi, Reza Ghasemikhah, Marzieh Soheili, Shnoo Bayazidi, Yousef Moradi

Clin Exp Pediatr. 2021;64(11):575-581. Published online February 5, 2021

Web of Science 10 Crossref 12

Is the global prevalence of toxocariasis high among children? The prevalence of toxocariasis is high in pediatric patients. Asian children are more susceptible to the disease than other children. Its virulence varies among different socioeconomic classes in various countries. Hand washing after soil contact, routine pet deworming, and appropriate disposal of pet feces in households with Asian pediatrics are needed to prevent toxocariasis.

DOI: https://doi.org/10.3345/cep.2020.01039

Original Article

Neurobehavior

Is there an association between labor induction and attention-deficit/hyperactivity disorder among children?

Ensiyeh Jenabi, Mahdieh Seyedi, Saeid Bashirian, Bita Fereidooni

Clin Exp Pediatr. 2021;64(9):489-493. Published online February 5, 2021

Web of Science 2 Crossref 3

· This meta-analysis pooled all observational (case-control and cohort) studies to obtain the association between labor induction and the risk of attention-deficit/hyperactivity disorder (ADHD) among children.
· The findings showed that labor induction is not associated with increased risk of ADHD among children.

DOI: https://doi.org/10.3345/cep.2020.01557

Editorial

Nephrology (Genitourinary)

Pulmonary thromboembolism: a rare but life-threatening complication of nephrotic syndrome

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.

DOI: https://doi.org/10.3345/cep.2020.01942

Review Article

Neonatology (Perinatology)

Clinical implications of coronavirus disease 2019 in neonates

Do-Hyun Kim

Clin Exp Pediatr. 2021;64(4):157-164. Published online February 4, 2021

Web of Science 11 Crossref 10

• Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) was detected in approximately 3% of neonates of mothers with coronavirus disease 2019 (COVID-19).
• Neonatal COVID-19 is relatively benign with 16%–22.4% cases asymptomatic.
• Neonates with pre-existing medical conditions and preterm infants are at a higher risk of severe COVID-19.
• Requirement for neonatal mechanical ventilation is 20%–22.4% (vs. 4% in children)
• Low birth weight (13.9%) and premature birth (22.2%) affect neonates of mothers with COVID-19.

DOI: https://doi.org/10.3345/cep.2020.01795

Clinical note

Neurology

Myelin oligodendrocyte glycoprotein antibody encephalitis following severe acute respiratory syndrome coronavirus 2 in a pediatric patient

Nusrat Ahsan, Saba Jafarpour, Jonathan D. Santoro

Clin Exp Pediatr. 2021;64(6):310-312. Published online February 1, 2021

Web of Science 18 Crossref 17

Question: Although neurologic complications have been reported during the acute phase of infection in children, less is known about the postinfectious phenomenon associated with the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) virus.
Finding: We present a case of a 7-year-old female with a prior asymptomatic infection with SARS-CoV-2 who subsequently developed encephalopathy and status epilepticus in association with myelin oligodendrocyte glycoprotein (MOG) antibody positivity.
Meaning: Here we present the first case of postinfectious of a MOG spectrum disorder associated with prior SARS-CoV-2 infection in a pediatric patient.

DOI: https://doi.org/10.3345/cep.2020.01963

Editorial

Hematology

Time to pay attention to anemia in female adolescents

Jae Min Lee

Clin Exp Pediatr. 2021;64(2):78-79. Published online February 1, 2021

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2020.02117

Original Article

Neurobehavior

Association between small for gestational age and risk of autism spectrum disorders: a meta-analysis

Ensiyeh Jenabi, Saeid Bashirian, Zahra Asali, Mahdieh Seyedi

Clin Exp Pediatr. 2021;64(10):538-542. Published online January 28, 2021

Web of Science 18 Crossref 19

• The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) and remains conflicting.
• We showed based on odds ratio reports in epidemiological studies that SGA can increase the risk of ASD and SGA is a risk factor for ASD.
• The association between SGA and the risk of ASD has further momentum to the current public health emphasis on appropriate prepregnancy weight and weight gain during pregnancy

DOI: https://doi.org/10.3345/cep.2020.01956

Editorial

Nutrition

Advantages and limitations of using national survey datasets in child and adolescent research

Yoon Lee

Clin Exp Pediatr. 2021;64(9):468-470. Published online January 26, 2021

The Korean National Health and Nutrition Examination Survey and the Korea Youth Risk Behavior Web-based Survey are major nationwide health and nutrition surveys in Korea. Although these surveys have some limitations of cross-sectional sample surveys, the accumulated data are valuable and provide new prospects for understanding public health depending on the interpretation method.

DOI: https://doi.org/10.3345/cep.2020.02110

Original Article

Endocrinology

Correlation between total air pollutant emissions and incidence of type 1 diabetes in the Russian Federation

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

Web of Science 4 Crossref 4

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.

DOI: https://doi.org/10.3345/cep.2020.01501

Allergy

Sex-based differences in factors associated with bronchial hyperresponsiveness in adolescents with childhood asthma

Young Hwan Kim, Yoon Young Jang, Jieun Jeong, Hai Lee Chung

Clin Exp Pediatr. 2021;64(5):229-238. Published online January 14, 2021

Web of Science 7 Crossref 7

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.

DOI: https://doi.org/10.3345/cep.2020.01585

Editorial

Other

Is correcting exposure misclassification bias an additional option in meta-analyses?

Ki Eun Kim

Clin Exp Pediatr. 2021;64(3):117-118. Published online January 14, 2021

Systematic reviews and meta-analyses examine various existing research results. Such studies are conducted according to a technically determined algorithm to minimize errors. It is particularly important to understand basic analytical methods such as the fixed-effect and random-effects models and apply appropriate statistical techniques to verify interstudy heterogeneity. A design that eliminates possible bias from the early stages of the research in a step-by-step manner is required whenever possible.

DOI: https://doi.org/10.3345/cep.2020.00325

Review Article

Allergy

Eosinophils and childhood asthma

Bong Seok Choi

Clin Exp Pediatr. 2021;64(2):60-67. Published online January 6, 2021

Web of Science 11 Crossref 12

•In allergic eosinophilic asthma, eosinophils act as important effector cells and antigen-presenting cells, while in nonallergic eosinophilic asthma, type 2 innate lymphoid cells play an important role in eosinophil activation.
•Sputum eosinophil counts can be helpful for evaluating allergic airway inflammation in asthma.
• Anti-interleukin-5 has broadened the scope of asthma treatment.

DOI: https://doi.org/10.3345/cep.2020.00717

Original Article

Allergy

Cohort profile: National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008)

Ju Hee Kim, Jung Eun Lee, So Min Shim, Eun Kyo Ha, Dong Keon Yon, Ok Hyang Kim, Ji Hyeon Baek, Hyun Yong Koh, Kyu Young Chae, Seung Won Lee, Man Yong Han

Clin Exp Pediatr. 2021;64(9):480-488. Published online January 5, 2021

Web of Science 50 Crossref 49

This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data.

DOI: https://doi.org/10.3345/cep.2020.01284

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?

Ji Young Park

Clin Exp Pediatr. 2021;64(6):284-285. Published online January 5, 2021

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2020.01830

Review Article

General Pediatrics

Clinical features, diagnosis, and outcomes of multisystem inflammatory syndrome in children associated with coronavirus disease 2019

Ji Hee Kwak, Soo-Young Lee, Jong-Woon Choi; the Korean Society of Kawasaki Disease

Clin Exp Pediatr. 2021;64(2):68-75. Published online December 30, 2020

Web of Science 58 Crossref 63

Hundreds of cases of children and adolescents with hyperinflammatory responses such as Kawasaki disease have been reported amid the coronavirus disease 2019 (COVID-19) pandemic, leading to coining of the new term COVID-19–associated multisystem inflammatory syndrome in children. In this review article, we introduce the illness and describe its case definitions, epidemiology, pathogenesis, clinical features, treatments, and outcomes.

DOI: https://doi.org/10.3345/cep.2020.01900

Editorial

Gastroenterology

Does smartphone overuse affect functional gastrointestinal disorders?

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.

DOI: https://doi.org/10.3345/cep.2020.01935

Review Article

Nutrition

Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data

Minji Kang, So Yoon Choi, Minyoung Jung

Clin Exp Pediatr. 2021;64(9):443-458. Published online December 28, 2020

Web of Science 9 Crossref 8

In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk...

DOI: https://doi.org/10.3345/cep.2020.01655

Critical Care Medicine

Pediatric postintensive care syndrome: high burden and a gap in evaluation tools for limited-resource settings

Chanapai Chaiyakulsil, Rapee Opasatian, Paweethida Tippayawong

Clin Exp Pediatr. 2021;64(9):436-442. Published online December 18, 2020

Web of Science 4 Crossref 8

Pediatric postintensive care syndrome has high impact and burden and can affect a child’s life for decades. The early evaluation and detection of such problems require a simple and less time-consuming surveillance tool. Current evaluation tools can be difficult and strenuous for areas with limited resources. Thus, a new simple tool is required for the early detection and intervention of postintensive care syndrome in critically ill children

DOI: https://doi.org/10.3345/cep.2020.01354

Perspective

Infection

Addressing children’s health amid the coronavirus disease 2019 pandemic

Young June Choe, Bilal Aurang Zeb Durrani, Stefan Swartling Peterson

Clin Exp Pediatr. 2021;64(2):46-48. Published online December 15, 2020

Web of Science 1 Crossref 1

In the coronavirus disease 2019 (COVID-19) pandemic, children experience heightened barriers to health and protective services. Children may also be disproportionately affected due to their reliance on the education system for daily tasks and lack of access to remote learning options. Republic of Korea findings on how vaccination coverage could be sustained in children and schools could be reopened without aggravating COVID-19 underlie the need for coordinated efforts across sectors.

DOI: https://doi.org/10.3345/cep.2020.01473

Editorial

Neonatology (Perinatology)

Which factors predict outcomes of neonates with hypoxic-ischemic encephalopathy following therapeutic hypothermia?

Gyu Hong Shim

Clin Exp Pediatr. 2021;64(4):169-171. Published online December 11, 2020

Web of Science 4 Crossref 4

Determining the therapeutic hypothermia and predict long-term prognosis quickly and accurately in infants with moderate to severe hypoxic-ischemic encephalopathy requires a thorough history taking, physical examination, amplitude-integrated electroencephalography, brain magnetic resonance imaging with diffusion-weighted imaging and proton magnetic resonance spectroscopy, heart evaluation (cardiac enzymes, electrocardiography, and echocardiography), and several other biomarkers.

DOI: https://doi.org/10.3345/cep.2020.01459

Infection

Catheter care bundle and feedback to prevent central line-associated bloodstream infections in pediatric patients

Hye-Kyung Cho

Clin Exp Pediatr. 2021;64(3):119-120. Published online December 8, 2020

Web of Science 3 Crossref 4

• Intravascular catheter-related infection is an important cause of morbidity and mortality in children, and care bundles are effective and cost-saving in pediatric and neonatal patients.
• Providing regular feedbacks to critical care practitioners is helpful to maintain compliance to care bundle.
• Establishing a bundle policy (insertion and maintenance), monitoring compliance, and providing regular feedbacks are necessary for prevention of central line-associated bloodstream infections in pediatric patients.

DOI: https://doi.org/10.3345/cep.2020.01186

Clinical note

Immunology

Salivary and lacrimal gland enlargement with serum immunoglobulin G4 elevation

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.

DOI: https://doi.org/10.3345/cep.2020.01319

Editorial

Cardiology

Where should we start to improve pediatric heart transplantation outcomes?

Jinyoung Song

Clin Exp Pediatr. 2021;64(2):76-77. Published online November 25, 2020

· Pediatric heart transplantation is achieving better outcomes.
· The waitlist mortality is still high, especially in Korea, and should be reduced.
· The use of ventricular assist device is promising and might offer improved waitlist mortality rates.

DOI: https://doi.org/10.3345/cep.2020.00584

Guideline

Endocrinology

2017 Clinical practice guidelines for dyslipidemia of Korean children and adolescents

Jung Sub Lim, Eun Young Kim, Jae Hyun Kim, Jae-Ho Yoo, Kyung Hee Yi, Hyun Wook Chae, Jin-Ho Choi, Ji Young Kim, Il Tae Hwang; the Committee of Dyslipidemia of Korean Children and Adolescents on behalf of Korean Society of Pediatric Endocrinology (KSPE)

Clin Exp Pediatr. 2020;63(12):454-462. Published online November 25, 2020

Web of Science 9 Crossref 10

Question: How are children and adolescents with dyslipidemia treated and managed in Korea?
Finding: 2017 guidelines recommend to measure nonfasting non-HDL-C as a screening test and introduce new diet methods: Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, CHILD-2-low-density lipoprotein cholesterol, and CHILD-2-triglyceride. Statin is the only drug approved in children older than 10 years.
Meaning: New clinical practice guidelines for treating and managing dyslipidemia of Korean children and adolescents are provided.

DOI: https://doi.org/10.3345/cep.2020.01340

Original Article

Infection

Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis

Farhad Sarrafzadeh, Seyed Mojtaba Sohrevardi, Hamid Abousaidi, Hossein Mirzaei

Clin Exp Pediatr. 2021;64(8):415-421. Published online November 20, 2020

Web of Science 8 Crossref 7

The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran.

DOI: https://doi.org/10.3345/cep.2020.00255

Perspective

Other

Role of the Korea National Institute of Health in the children’s health effect study of particulate matter

Young Youl Kim

Clin Exp Pediatr. 2021;64(4):139-140. Published online November 17, 2020

Particulate matter (PM) adversely affects children’s lungs and cognitive development, and an early exposure to it can lead to chronic metabolic diseases. The Korea National Institute of Health convened a Task Force on the Health Impact of PM to produce scientific evidence and promote technological developments to prevent PM-induced health effects.

DOI: https://doi.org/10.3345/cep.2020.00780

Original Article

Nutrition

Impact of preoperative nutritional status on surgical outcomes in patients with pediatric gastrointestinal surgery

Nehal El Koofy, Hadeer Mohamed Nasr Eldin, Wesam Mohamed, Mostafa Gad, Sara Tarek, Gamal El Tagy

Clin Exp Pediatr. 2021;64(9):473-479. Published online November 16, 2020

Web of Science 8 Crossref 12

Question: Is malnutrition a risk factor for postoperative complications in pediatric surgical patients?
Finding: There is a high incidence of malnutrition in pediatric surgical patients. Stunting increases the risks of postoperative complications and extended hospital stays, while underweight status contributes to extended hospital stays.
Meaning: Preoperative nutritional assessments are crucial to improving postoperative outcomes. Anemia increases the risk of postoperative complications and should be corrected preoperatively.

DOI: https://doi.org/10.3345/cep.2020.00458

Clinical note

Nephrology (Genitourinary)

Extracorporeal membrane oxygenation with systemic heparinization as a rescue therapy for acute life-threatening pulmonary thromboembolism complicating nephrotic syndrome

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

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2020.01550

Original Article

Hematology

Changes in the prevalence of anemia in Korean adolescents, 1998–2018

Jun Young An, Yoo Rha Hong, Seom Gim Kong

Clin Exp Pediatr. 2021;64(2):86-92. Published online November 16, 2020

Web of Science 2 Crossref 2

Question: Over the past 21 years, has the prevalence of anemia decreased among Korean adolescents?
Finding: The prevalence of anemia in boys aged 10–18 years decreased from 3.0% to 0.5% over the study period, whereas that in girls did not change significantly over time (increased from 7.9% to 8.5%).
Meaning: The prevalence of anemia in female adolescents remains high, requiring attention and efforts to improve it.

DOI: https://doi.org/10.3345/cep.2020.01508

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