Clinical and Experimental Pediatrics

Original Article

Hematology

Effects of α-tocopherol on hemolysis and oxidative stress markers on red blood cells in β-thalassemia major

Nora Sovira, Munar Lubis, Pustika Amalia Wahidiyat, Franciscus D. Suyatna, Djajadiman Gatot, Saptawati Bardosono, Mohammad Sadikin

Clin Exp Pediatr. 2020;63(8):314-320. Published online August 15, 2020

Web of Science 12 Crossref 11

Question: Is the α-tocopherol as an exogenous antioxidant supplementation effective in improving hemolysis and oxidative stress on β-thalassemia major?
Finding: We found significant enhancements in plasma haptoglobin were noted in the α-tocopherol group (3.01 mg/dL; range, 0.60–42.42 mg/dL; P=0.021).
Meaning: The α-tocopherol can improve hemolysis by increasing the haptoglobin level as hemolysis marker.

DOI: https://doi.org/10.3345/cep.2019.00542

Editorial

Nutrition

Pivotal roles of prolactin and other hormones in lactogenesis and the nutritional composition of human milk

Yong Joo Kim

Clin Exp Pediatr. 2020;63(8):312-313. Published online August 15, 2020

Web of Science 8 Crossref 7

DOI: https://doi.org/10.3345/cep.2020.00311

Neurology

Commentary on "Autoimmune encephalitis and epilepsy: evolving definition and clinical spectrum"

Jieun Choi

Clin Exp Pediatr. 2020;63(8):310-311. Published online August 15, 2020

DOI: https://doi.org/10.3345/cep.2020.00353

Review Article

Allergy

Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis

Hye Yung Yum, Eun Kyo Ha, Yoon Ho Shin, Man Yong Han

Clin Exp Pediatr. 2021;64(8):373-383. Published online August 10, 2020

Web of Science 17 Crossref 21

Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%–89% of the chronic rhinitis cases, affecting 1%–50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally...

DOI: https://doi.org/10.3345/cep.2020.00822

Critical Care Medicine

The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

Silver Heinsar, Sainath Raman, Jacky Y. Suen, Hwa Jin Cho, John F. Fraser

Clin Exp Pediatr. 2021;64(5):188-195. Published online August 10, 2020

Web of Science 10 Crossref 14

Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation...

DOI: https://doi.org/10.3345/cep.2020.00836

Adolescence Medicine

The impacts of exercise on pediatric obesity

Ronald J. Headid III, Song-Young Park

Clin Exp Pediatr. 2021;64(5):196-207. Published online August 4, 2020

Web of Science 29 Crossref 33

Pediatric obesity contributes to the development of vascular dysfunction and metabolic and cardiovascular diseases which have all been shown to track into adulthood, increasing the risk of early mortality. Early exercise intervention is critical for combating obesity-related comorbidities and the optimal exercise prescription has yet to be well documented. Exercise prescriptions to combat pediatric obesity should incorporate both aerobic and muscle-strengthening exercises with an emphasis on long-term adherence.

DOI: https://doi.org/10.3345/cep.2020.00997

Original Article

Other

Association between pesticide and polychlorinated biphenyl exposure during pregnancy and autism spectrum disorder among children: a meta-analysis

Fereshteh Mehri, Saeid Bashirian, Salman khazaei, Ensiyeh Jenabi

Clin Exp Pediatr. 2021;64(6):286-292. Published online July 27, 2020

Web of Science 9 Crossref 5

· This meta-analysis analyzed the association between pesticide and polychlorinated biphenyl (PCB) exposure during pregnancy and autism spectrum disorders (ASD) risk among children.
· A significant association was noted between PCB and pesticide exposure during pregnancy and ASD risk among children (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.26–2.34 and OR, 1.20; 95% CI, 1.02–1.39), respectively.
· Pesticide and PCB exposure during pregnancy may affect ASD risk among children.

DOI: https://doi.org/10.3345/cep.2020.00864

Perspective

Neurology

How can pediatricians treat neurodevelopmental disorders

Young-Hoon Kim

Clin Exp Pediatr. 2021;64(1):1-2. Published online July 27, 2020

Web of Science 1 Crossref 2

∙ Recently neurodevelopmental therapy for preschool-aged children with neurodevelopmental disorders is paid for by health insurance in Korea.
∙ There are good evidences that parenting programs and neurodevelopmental therapy can work in attention deficit hyperactivity disorder and autism spectrum disorder.
∙ Pediatricians must be able to pass away important information to parents.

DOI: https://doi.org/10.3345/cep.2020.00507

Clinical Note

Neonatology (Perinatology)

Secondary renal tubular dysgenesis in a newborn exposed to angiotensin Ⅱ receptor antagonist during gestation

Mi Hyeon Gang, Yong Wook Lee, Mea-young Chang

Clin Exp Pediatr. 2021;64(3):136-138. Published online July 21, 2020

Web of Science 4 Crossref 6

Question: The use of renin-angiotensin system (RAS) blockers during pregnancy causes lethal neonatal complications.
Finding: A neonate, whose mother took a RAS blocker during pregnancy, was diagnosed with renal tubular dysgenesis. He presented with respiratory failure, severe refractory hypotension, and anuria requiring continuous dialysis.
Meaning: Physicians should consider any degree of RAS fetopathy in a newborn born to a hypertensive mother who had use of RAS blockers during her pregnancy.

DOI: https://doi.org/10.3345/cep.2020.00752

Original Article

Gastroenterology

Noninvasive markers for esophageal varices in children with cirrhosis

Parisa Rahmani, Fatemeh Farahmand, Ghobad Heidari, Azadeh Sayarifard

Clin Exp Pediatr. 2021;64(1):31-36. Published online July 21, 2020

Web of Science 8 Crossref 9

Question: Can noninvasive biomarkers identify esophageal varices among children with esophageal cirrhosis?
Finding: The spleen size, platelet count, international normalized ratio, aspartate aminotransferase to platelet ratio index, platelet count to spleen size ratio, and risk score differed significantly between the patients with and those without esophageal varices.
Meaning: These biological parameters can predict esophageal varices among pediatric patients and indicate the need for esophagogastroduodenoscopy.

DOI: https://doi.org/10.3345/cep.2019.01599

Evaluating the effects of probiotics in pediatrics with recurrent abdominal pain

Parisa Rahmani, Azin Ghouran-orimi, Farzaneh Motamed, Alireza Moradzadeh

Clin Exp Pediatr. 2020;63(12):485-490. Published online July 21, 2020

Web of Science 19 Crossref 21

Question: ecurrent abdominal pain (RAP) is a chief complaint among pediatrics and is associated with reduced quality of life, for both parent and child, and economic burden. Does probiotics reduce the frequency of RAP among children?
Finding: This study reported the effects of Lactobacillus reuteri probiotics among children with RAP as a result of multiple etiologies.
Meaning: The administration of probiotic supplements is significantly associated with pain relief among RAP children presented with functional abdominal pain, irritable bowel syndrome, and functional dyspepsia.

DOI: https://doi.org/10.3345/cep.2019.01613

Neonatology (Perinatology)

Knowledge and perceptions of kangaroo mother care among health providers: a qualitative study

Hadi Pratomo, Tiara Amelia, Fatmawati Nurlin, Asri C. Adisasmita

Clin Exp Pediatr. 2020;63(11):433-437. Published online July 21, 2020

Web of Science 7 Crossref 7

Question: What are health providers’ knowledge and perceptions of Kangaroo mother care (KMC)?
Finding: Health providers’ knowledge of KMC was sufficient; however, some of their perceptions about it could create barriers to the successful implementation of hospital KMC programs.
Meaning: Health providers’ perceptions about KMC should be considered to ensure successful KMC implementation. Locally designed on-site training programs could overcome the challenges.

DOI: https://doi.org/10.3345/cep.2018.06506

Clinical Note

Nephrology (Genitourinary)

First episode of nephrotic syndrome with acute abdominal pain

Samridhi Goyal, Rachita Singh Dhull, Bobbity Deepthi, Abhijeet Saha

Clin Exp Pediatr. 2020;63(10):411-414. Published online July 21, 2020

Question: What are the likely causes of pain abdomen in Nephrotic syndrome?
Finding: Severe hypovolemia leading to mesenteric ischemia, spontaneous bacterial peritonitis, gastroenteritis, adverse effect of corticosteroids leading to gastritis, mesenteric ischemia due to thromboembolism, acute appendicitis, intussusception due to severe gut wall oedema and rarely Psoas abscess.
Meaning: Clinical suspicion and careful investigation is warranted to diagnose rare cause of pain abdomen like Psoas abscess.

DOI: https://doi.org/10.3345/cep.2019.01333

Original Article

Cardiology

Age-, sex-, and height-based blood pressure reference charts, Yazd children 6–18 years, Iran

Nastaran ahmadi, Seyedeh Mahdieh Namayandeh, Seyed Mahmood Sadr Bafghi, Mohammad Reza Mohammadi, Masoud Mirzaei, Mohammadtaghi Sarebanhassanabadi, Amir Houshang Mehrparvar, Reza Faraji, Neda Nilforoshan, Ahmad Karimi

Clin Exp Pediatr. 2020;63(8):321-328. Published online July 21, 2020

Web of Science 4 Crossref 4

Question: What is the 90th, 95th, 99th percentile of blood pressure based on height as the cut point for diagnosis of hypertension in children of our province?
Finding: We used blood pressure of 456 males and 579 females in 6–18 years old in “Iranian Children and Adolescents' Psychiatric Disorders survey.
Meaning: The 90th, 95th, 99th percentiles of systolic and diastolic blood pressure in both sex based on age and 10-cm height intervals were developed in Yazd.

DOI: https://doi.org/10.3345/cep.2019.00094

Editorial

Neonatology (Perinatology)

Fluconazole prophylaxis for prevention of invasive candidiasis in extremely preterm infants

Chun Soo Kim

Clin Exp Pediatr. 2021;64(4):167-168. Published online July 17, 2020

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2020.00745

Infection

What are considerations for neonates at risk for COVID-19?

Soo-Han Choi

Clin Exp Pediatr. 2020;63(9):359-360. Published online July 17, 2020

DOI: https://doi.org/10.3345/cep.2020.01074

Review Article

Pulmonology

Overview of management of children with COVID-19

Dyah Kanya Wati, Arya Krisna Manggala

Clin Exp Pediatr. 2020;63(9):345-354. Published online July 17, 2020

Web of Science 5 Crossref 4

The specific treatments for COVID-19 in children remain inconclusive and debatable despite effectively decreasing its signs and symptoms.
The need for clinical trials and reports should be investigated.

DOI: https://doi.org/10.3345/cep.2020.00913

Genetics and Metabolism

Understanding the genetics of systemic lupus erythematosus using Bayesian statistics and gene network analysis

Seoung Wan Nam, Kwang Seob Lee, Jae Won Yang, Younhee Ko, Michael Eisenhut, Keum Hwa Lee, Jae Il Shin, Andreas Kronbichler

Clin Exp Pediatr. 2021;64(5):208-222. Published online July 15, 2020

Web of Science 2 Crossref 3

Bayesian false-discovery probability and false-positive report probability are the 2 major Bayesian methods used to evaluate noteworthiness of a genetic variant.
Application of stricter P value is needed to confirm statistical significance in meta-analyses.
Gene network analysis of noteworthy genetic variants shows a blueprint of the genetic background in complex diseases.

DOI: https://doi.org/10.3345/cep.2020.00633

Neurofibromatosis type I: points to be considered by general pediatricians

Eungu Kang, Hee Mang Yoon, Beom Hee Lee

Clin Exp Pediatr. 2021;64(4):149-156. Published online July 15, 2020

Web of Science 15 Crossref 17

Neurofibromatosis type 1 (NF1), a prevalent genetic disease that is transmitted in an autosomal dominant manner, is characterized by multiple cutaneous café-au-lait spots and neurofibromas as well as various degrees of neurological, skeletal, and neoplastic manifestations. The clinical features of NF1 increase in frequency with age, while the clinical diagnosis can remain undetermined in some pediatric patients. Importantly, affected patients...

DOI: https://doi.org/10.3345/cep.2020.00871

Other

Behavioral insomnia in infants and young children

Eun Kyeong Kang, Seung Soo Kim

Clin Exp Pediatr. 2021;64(3):111-116. Published online July 15, 2020

Web of Science 13 Crossref 16

• Behavioral insomnia is common and affects a child’s daytime functioning and emotions.
• Diagnosing insomnia using the child’s sleep history, a sleep diary/log, and sleep questionnaires is important.
• Behavioral intervention, the main treatment, involves creating positive associations with sleep, establishing a consistent sleep schedule and bedtime routines, and the development of selfsoothing skills.

DOI: https://doi.org/10.3345/cep.2020.00052

Original Article

Neonatology (Perinatology)

The protective effect of CXC chemokine receptor 2 antagonist on experimental bronchopulmonary dysplasia induced by postnatal systemic inflammation

Seung Hyun Lee, Chang Won Choi

Clin Exp Pediatr. 2021;64(1):37-43. Published online July 15, 2020

Web of Science 4 Crossref 3

Question: Can CXC chemokine receptor 2 (CXCR2) antagonist preserve alveolarization by attenuating the inflammation induced by systemic lipopolysaccharide (LPS) administration in a rat model of bronchopulmonary dysplasia (BPD)?
Finding: CXCR2 antagonist significantly decreased neutrophil counts in bronchoalveolar lavage fluid and peripheral blood induced by systemic LPS administration and restored alveolarization in newborn rats.
Meaning: CXCR2 antagonist protected the lungs from the inflammation in a rat model of BPD.

DOI: https://doi.org/10.3345/cep.2020.00381

Review Article

Gastroenterology

Changing prevalence of Helicobacter pylori infection in children and adolescents

Ji Sook Park, Jin Su Jun, Ji-Hyun Seo, Hee-Shang Youn, Kwang-Ho Rhee

Clin Exp Pediatr. 2021;64(1):21-25. Published online July 15, 2020

Web of Science 34 Crossref 39

Although Helicobacter pylori infection rate in children is unclear due to diversity and limitation of diagnostic tests unlike in adults, investigation the childhood prevalence is important for predicting H. pylori-related diseases in the future.
H. pylori infection occurred in early childhood, and declined during 30 years in our study.
Change in risk factors of H. pylori transmission and consensus for eradication therapy in children might further reduce the infection rate.

DOI: https://doi.org/10.3345/cep.2019.01543

Original Article

Neonatology (Perinatology)

New modified version of the Risk Adjustment for Congenital Heart Surgery category and mortality in premature infants with critical congenital heart disease

Young Mi Yoon, Seong Phil Bae, Yoon-Joo Kim, Jae Gun Kwak, Woong-Han Kim, Mi Kyoung Song, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim

Clin Exp Pediatr. 2020;63(10):395-401. Published online July 15, 2020

Web of Science 3 Crossref 4

Questions: This study aimed to describe the survival of premature infants with critical congenital heart disease (CHD) and to identify the risk factors including the new modified version of the Risk Adjustment for Congenital Heart Surgery (M-RACHS) associated with mortality.
Finding: For premature infants with critical CHD, survival rate was 76.9% and very low birth weight (VLBW), persistent pulmonary hypertension of the newborn (PPHN), bronchopulmonary dysplasia (BPD), and M-RACHS 5 or more were associated with in-hospital mortality.
Meaning: VLBW, PPHN and BPD, as well as M-RACHS≥5, were risk factors for mortality among premature infants with critical CHD.

DOI: https://doi.org/10.3345/cep.2019.01522

Critical Care Medicine

Can central venous access device care bundles and regular feedback reduce central line-associated complications in pediatric patients?

Chanapai Chaiyakulsil, Onsuthi Pharadornuwat

Clin Exp Pediatr. 2021;64(3):123-129. Published online July 14, 2020

Web of Science 12 Crossref 11

Question: Can central line bundles and feedback reduce central line-associated complications in pediatric patients?
Finding: The central line-related bloodstream infection rate decreased from 10.0 catheter-days to 1.4/1,000 catheter-days at 6-month postintervention. The central line occlusion rate was also decreased.
Meaning: Reinforcing central line care bundles with direct feedback can significantly decrease central line-associated complications in pediatric patients.

DOI: https://doi.org/10.3345/cep.2020.00143

Review article

Immunology

Systematic review of literature and analysis of big data from the National Health Insurance System on primary immunodeficiencies in Korea

Sohee Son, Ji-Man Kang, Younsoo Hahn, Kangmo Ahn, Yae-Jean Kim

Clin Exp Pediatr. 2021;64(4):141-148. Published online July 13, 2020

Crossref 4

In this article, a systematic review of reported primary immunodeficiency disease (PID) cases in Korea was performed and we attempted to estimate the number of PID patients and healthcare costs for the first time in Korea. Our review revealed that Korean PID cases are greatly underreported in the literature based on health insurance. Physicians in the field and health care policymakers should be aware of the disease burden of PID.

DOI: https://doi.org/10.3345/cep.2019.01347

Editorial

General Pediatrics

Why should we be concerned about early menarche?

Hae Sang Lee

Clin Exp Pediatr. 2021;64(1):26-27. Published online July 13, 2020

Crossref 25

· Early menarche is associated with several health problems in later life.
· Early menarche can be caused by environmental factors such as increased subcutaneous fat, a high body mass index, and sugar-sweetened beverages as well as genetic factors.
· Health education can prevent early menarche by aiming to reduce the consumption of fructose, high concentrations of which are present in sugar-sweetened beverages.

DOI: https://doi.org/10.3345/cep.2020.00521

Original Article

Nephrology (Genitourinary)

Sonographic renal length and volume of normal Thai children versus their Chinese and Western counterparts

Chantima Rongviriyapanich, Thanarat Sakunchit, Chirawat Sudla, Supamas Mungkung, Napapong Pongnapang, Chai Hong Yeong

Clin Exp Pediatr. 2020;63(12):491-498. Published online July 13, 2020

Crossref 4

Question: What is the normal renal size of Thai children and is the renal nomogram comparable to those of Western and Chinese cohorts?
Finding: The renal length of Thai children was moderately correlated with that of Western children, while the age-specific renal volume was significantly smaller than that of Chinese children.
Meaning: Renal size in children can vary among regions and sociodemographic backgrounds; hence, a local reference standard is needed.

DOI: https://doi.org/10.3345/cep.2019.01676

Clinical Note

Neonatology (Perinatology)

Management of the first newborn delivered by a mother with COVID-19 in South Korea

Eun-Kyung Lee, Won Duck Kim, Dong won Lee, Sang-Ah Lee

Clin Exp Pediatr. 2020;63(9):373-375. Published online July 13, 2020

Crossref 5

Question: How to manage the newborn born to the coronavirus disease 2019 (COVID-19) pregnant?
Finding: Medical staff managed the delivery and neonatal care of a COVID-19 pregnant patient was based on the “Guidelines for COVID-19 response.”
Meaning: We desire that our management will help treat for subsequent patients and there should be updated continuously the prevention and control consensus strategies for newborn COVID-19.

DOI: https://doi.org/10.3345/cep.2020.00850

Editorial

Gastroenterology

Dietary role in the development and treatment of inflammatory bowel disease

Jae Young Kim

Clin Exp Pediatr. 2020;63(9):355-356. Published online July 13, 2020

Web of Science 1 Crossref 1

Although the precise pathogenesis of inflammatory bowel disease (IBD) is unclear, dietary factors seem to play a significant role. Dietary modifications including enteral nutrition and the Crohn disease exclusion, specific carbohydrate, and anti-inflammatory diets show a potential ability to downregulate gut inflammation. These nutritional interventions have various degree of efficacies with limited side effects profile for treating pediatric IBD, but data from randomized prospective studies are lacking, and further studies are warranted.

DOI: https://doi.org/10.3345/cep.2020.00080

Perspective

Infection

Can we get a clue for the etiology of Kawasaki disease in the COVID-19 pandemic?

Jong-Woon Choi

Clin Exp Pediatr. 2020;63(9):335-336. Published online July 13, 2020

Web of Science 5 Crossref 6

A new coronavirus disease 2019 (COVID-19) has been spreading globally since December 2019. Children with a Kawasaki disease (KD)-like illness related with COVID-19 have been reported in Europe and the United States. They presented with symptoms of KD with or without cardiac abnormalities or shock, showing manifestations of hyperactive proinflammatory cytokine reactions like KD. Such cases may provide the opportunity for us to learn more about the etiology and pathogenesis of KD.

DOI: https://doi.org/10.3345/cep.2020.00955

Cited By 28	Neurodevelopmental outcomes of preterm infants
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