Clinical and Experimental Pediatrics

Original Article

Allergy

Regional differences in diagnosis and management of cow's milk allergy

Fabian Hendricx, Emma Robert, Jaime A. Ramirez-Mayans, Karen Rubi Ignorosa Arellano, Erick M. Toro Monjaraz, Yvan Vandenplas

Clin Exp Pediatr. 2024;67(11):601-607. Published online October 28, 2024

· Although there is broad consensus on many aspects regarding the symptoms, diagnosis, and treatment of cow's milk allergy, the impact of geographical, cultural, and socioeconomic factors remains unestablished.
· Availability and cost of formula for the management of cow's milk allergy have a major impact on the therapeutic choice.
· Region-specific guidelines for the treatment of cow's milk allergy are required.

DOI: https://doi.org/10.3345/cep.2023.01550

Review Article

Neurology

Role of nonpharmacological concussion management in children: systematic review of randomized controlled trials

Andre Marolop Pangihutan Siahaan, Alvin Ivander, Rr. Suzy Indharty, Steven Tandean, Anastasia Grace Milenia Ginting, Masrini Ginting, Felix Khosasi, Elbert

Clin Exp Pediatr. 2024;67(11):569-579. Published online October 28, 2024

The long-term effects of concussion for pediatric patient remains unclear. Children and teenagers do not experience or recover from concussion in the same manner as adults do. Concussions can cause a variety of anatomical and functional alterations. Nonpharmacological approach in pediatric concussion management is an understudied field of research with significant ability to affect prognosis and quality of life. Active rehabilitation and occupational therapy were especially promising.

DOI: https://doi.org/10.3345/cep.2023.01256

Endocrinology

Growth plate closure and therapeutic interventions

Ja Hyang Cho, Hae Woon Jung, Kye Shik Shim

Clin Exp Pediatr. 2024;67(11):553-559. Published online October 28, 2024

Height gains result from longitudinal bone growth. Upon adequate growth, growth plate closure limits longitudinal bone growth. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure and increase human height. The development of more effective therapeutic modalities for short stature, precocious puberty, and skeletal dysplasia is anticipated.

DOI: https://doi.org/10.3345/cep.2023.00346

Original Article

Neonatology (Perinatology)

Protective effect of recombinant interleukin-10 on newborn rat lungs exposed to short-term sublethal hyperoxia

Hyeon-Soo Lee, Young-Joon Ryu, Min-Jae Lee

Clin Exp Pediatr. 2024;67(10):540-549. Published online September 27, 2024

Lung injury is generated from the early stage of hyperoxia through the biologic effects of cell death and inflammatory response, which eventually leads to evolution of bronchopul-monary dysplasia. Therefore, a protective measure against hyperoxia-induced lung injury is needed. The present study observed that anti-inflammatory cytokine, interleukin-10 had protective effects on newborn rat lungs from injury induced at the early stage of hyperoxia, by preventing cell death and down-regulating inflammatory response.

DOI: https://doi.org/10.3345/cep.2024.01221

General Pediatrics

Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: a randomized controlled trial

Fatma Şule Bilgiç, Gülçin Bozkurt

Clin Exp Pediatr. 2024;67(10):521-530. Published online September 27, 2024

Question: Do interventions based on Meleis' transition theory affect mothers' readiness for baby care and breastfeeding?
Findings: We found a statistically significant difference between the intervention and control groups in mothers' readiness for newborn care and breastfeeding (P<0.001).
Meaning: This intervention increased breastfeeding rates while ensuring that mothers were ready to care for their babies and prepared for the role of motherhood.

DOI: https://doi.org/10.3345/cep.2024.00423

Clinical Note

Immunology

Comparative analysis of rare periodic fever syndromes including the first Korean case of hyperimmunoglobulinemia D and periodic fever syndrome

Yoonsun Yoon, Hyun Seo Kim, Jung Ok Shim, JungHwa Lee

Clin Exp Pediatr. 2024;67(10):550-552. Published online September 24, 2024

Crossref 1

DOI: https://doi.org/10.3345/cep.2024.00787

Original Article

Nutrition

Energy drink consumption among Korean adolescents: prevalence and associated factors

Jee-Seon Shim, Jeong Mi Lee

Clin Exp Pediatr. 2024;67(10):531-539. Published online September 24, 2024

Web of Science 1 Crossref 1

Question: How prevalent is energy drink consumption among Korean adolescents and what are the associated factors?
Findings: The prevalence of energy drink consumption among Korean adolescents increased from 3.2% in 2014 to 12.2% in 2019. Energy drink consumption varies according to sociode-mographic and individual factors.
Meaning: Policies and educational strategies are needed to reduce energy drink consumption in adolescents.

DOI: https://doi.org/10.3345/cep.2024.00171

Review Article

Developmental and Behavioral Medicine

Effect of pesticide exposure on stunting incidence: a systematic review and meta-analysis

Sani Rachman Soleman, Yaltafit Abror Jeem, Muhammad Fathi Banna Al Faruqi, Mahdea Kasyiva, Vita Widyasari, Kuswati Kuswati, Nur Aini Djunet, Muflihah Rizkawati, Ety Sari Handayani

Clin Exp Pediatr. 2024;67(10):510-518. Published online September 24, 2024

This review aimed to determine whether pesticide exposure is associated with stunting in children. The 13 included studies agree that pesticide exposure is not correlated with stunting incidence regardless of substance type (organophosphate and pyrethroid). Heterogeneity appeared with age covariate as potential confounding. The evidence of this study is challeng-ing, as the adverse effects of pesticides grossly occurred. The protection of children is warranted for preventing future neurodevelopment issues.

DOI: https://doi.org/10.3345/cep.2023.01522

Original Article

Cardiology

Comparative analysis of adolescent hypertension definitions for predicting early adulthood carotid artery intima-media thickness: Tehran lipid and glucose study

Maryam Barzin, Shirin Yaghoobpoor, Maryam Mahdavi, Behnaz Abiri, Majid Valizadeh, Fereidoun Azizi, Pooneh Dehghan, Farhad Hosseinpanah

Clin Exp Pediatr. 2024;67(12):694-703. Published online September 12, 2024

Web of Science 2 Crossref 1

Question: What is the prevalence of HTN among adolescents enrolled in the TLGS according to 3 different accepted definitions (4th report, ESH, and AAP-CPG). Also, what is the ability of each of these definitions in predicting early adulthood CIMT, as a surrogate for cardiovascular disease events?
Finding: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. The highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively.
Meaning: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG.

DOI: https://doi.org/10.3345/cep.2024.00248

General Pediatrics

Role of proper postnatal care in continued exclusive breastfeeding among young Indonesian mothers

Wahyu Triadmajani, Shinta Prawitasari, Abdul Wahab

Clin Exp Pediatr. 2024;67(12):686-693. Published online September 12, 2024

Web of Science 1 Crossref 1

Question: Is proper postnatal care (PNC) associated with exclusive breastfeeding (EBF) practice among young Indonesian mothers?
Finding: Proper PNC elevates the likelihood of EBF among Indonesian adolescent mothers aged 15–19 years.
Meaning: Breastfeeding services should be provided during the early postnatal period to support EBF practice among adolescent mothers. High-quality PNC is a tailored intervention for vulnerable populations.

DOI: https://doi.org/10.3345/cep.2024.00815

Review Article

Developmental and Behavioral Medicine

Screen time among preschoolers: exploring individual, familial, and environmental factors

Sangha Lee, Donghee Kim, Yunmi Shin

Clin Exp Pediatr. 2024;67(12):641-650. Published online September 12, 2024

This systematic review examined the correlation between screen time and various factors in preschoolers. Findings suggest that media parenting, including setting appropriate media limits, is crucial in protecting against excessive screen exposure. However, limited research has been done on the impact of family and personal factors, particularly with the increasing use of portable devices among young children.

DOI: https://doi.org/10.3345/cep.2023.01746

Rheumatology

Double-negative T cells in pediatric rheumatic diseases

Dimitri Poddighe, Tilektes Maulenkul, Kuanysh Dossybayeva, Gulsamal Zhubanova, Zaure Mukusheva, Lyudmila Akhmaltdinova

Clin Exp Pediatr. 2024;67(12):632-640. Published online September 12, 2024

Web of Science 1 Crossref 1

Double-negative T (DNT) cells appear to be increased in several pediatric rheumatic diseases and this finding may be correlated with disease activity to some extent. However, due to significant heterogeneity in several methodological aspects, further investigations in rheumatic children are needed to assess the potential relevance of DNT cells as biomarkers and clarify their immunopathological role.

DOI: https://doi.org/10.3345/cep.2023.01760

Original Article

Neonatology (Perinatology)

Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status

Sung-Hoon Chung, Chae Young Kim, Yong-Sung Choi, Myung Hee Lee, Jae Woo Lim, Byong Sop Lee, Ki-Soo Kim; the Korean Neonatal Network

Clin Exp Pediatr. 2024;67(11):619-627. Published online September 12, 2024

Question: How do structural and staffing characteristics of neonatal intensive care units (NICUs) influence the mortality rates of very low birth weight infants (VLBWIs)?
Findings: NICUs with higher staffing levels, particularly with more neonatologists, and those offering advanced care levels were associated with lower mortality rates. Additionally, regional disparities were observed, with some areas demon-strating significantly higher survival rates.
Meaning: Adequate staffing and equitable regional distribution of medical resources are crucial for improving survival outcomes in VLBWIs. Efforts to enhance NICU staffing and address regional healthcare disparities are essential for optimizing care quality and reducing mortality in this vulnerable population.

DOI: https://doi.org/10.3345/cep.2023.01613

Letter to the Editor

Gastroenterology

Pediatric abdominal ultrasound training program for pediatricians

Soon Chul Kim

Clin Exp Pediatr. 2024;67(9):474-476. Published online August 20, 2024

DOI: https://doi.org/10.3345/cep.2024.00451

Review Article

Allergy

Comparison and review of international guidelines for treating asthma in children

Eui Jeong Roh

Clin Exp Pediatr. 2024;67(9):447-455. Published online August 20, 2024

Web of Science 1 Crossref 1

Asthma is the most common chronic disease among children. Although asthma in children may spontaneously improve, it continues into adulthood in many cases. Therefore, appropriate disease management and medication are essential. Consistent and objective guidelines are needed to manage pediatric asthma and related adverse reactions.

DOI: https://doi.org/10.3345/cep.2022.01466

Editorial

Allergy

Comorbidities of allergic rhinitis in children

Yong Ju Lee

Clin Exp Pediatr. 2024;67(12):675-676. Published online July 31, 2024

· Allergic rhinitis in children often goes undiagnosed or untreated, with significant systemic complications like sleep disorders, growth issues, and gastrointestinal symptoms linked to nasal obstruction.
· A patient-centered action plan that considers symptom severity, preferences, and comprehensive management of associated complications is essential for effective treatment.

DOI: https://doi.org/10.3345/cep.2024.00164

Advancements in food allergen immunotherapy: improving quality of life and reducing risks

Jihyun Kim

Clin Exp Pediatr. 2024;67(12):672-674. Published online July 31, 2024

· Pediatric food allergies considerably impair patient and family quality of life, particularly those with persistent allergies to common food allergens.
· Recent research has focused on developing diverse approaches to food allergen immunotherapy, showing promising outcomes of oral, sublingual, and epicutaneous immuno therapies.
· Critical considerations in immunotherapy candidate selection underscore the need for personalized approaches and reliable biomarkers in future studies to improve treatment outcomes.

DOI: https://doi.org/10.3345/cep.2023.01718

Review Article

Endocrinology

Lifelong medical challenges and immunogenetics of Turner syndrome

Won Kyoung Cho

Clin Exp Pediatr. 2024;67(11):560-568. Published online July 31, 2024

Web of Science 2 Crossref 3

· This summary emphasizes the importance of the early diagnosis of Turner syndrome (TS) and presents a multidisciplinary approach to its prevention and management, high-lighting the need for customized care.
· Advancements in immunogenetic research may improve our understanding of TS and improve its outcomes.
· TS encompasses a wide array of medical challenges, including cardiovascular, endocrine, autoimmune, and mental health issues, as well as a heightened cancer risk.

DOI: https://doi.org/10.3345/cep.2024.00430

Original Article

Genetics and Metabolism

Interleukin (IL)-1B and IL-1 receptor antagonist gene polymorphisms in children with primary immune thrombocytopenia

Seham Mohamed Ragab, Wafaa Moustafa Abo ElFotoh, Mahmoud Ahmed El-Hawy, Eman Abdelfatah Badr, Saara Khairat Ali Mostafa, Mai El-Sayad Abd El-Hamid

Clin Exp Pediatr. 2024;67(9):465-473. Published online July 24, 2024

· Polymorphisms in interleukin (IL)-1B and IL-1 receptor (IL-1R) antagonists may significantly affect the pathogenesis of immune thrombocytopenia (ITP).
· IL-1B and IL-1R antagonist gene polymorphisms are correlated with severity and susceptibility to primary ITP in children.

DOI: https://doi.org/10.3345/cep.2024.00577

Letter to the Editor

Hematology

Neutropenia following metamizole use in pediatric patients: a multicenter retrospective study

Meraj Alam Siddiqui, Arzu Akyay, Fatma Burcu Belen Apak, Özgür Carti, Canan Albayrak, Melek İşik, Zühre Kaya, Sevgi Yetgin, Lale Olcay

Clin Exp Pediatr. 2024;67(8):415-417. Published online July 23, 2024

DOI: https://doi.org/10.3345/cep.2024.00262

Original Article

Infection

Construction and validation of predictive models for intravenous immunoglobulin–resistant Kawasaki disease using an interpretable machine learning approach

Linfan Deng, Jian Zhao, Ting Wang, Bin Liu, Jun Jiang, Peng Jia, Dong Liu, Gang Li

Clin Exp Pediatr. 2024;67(8):405-414. Published online July 23, 2024

Web of Science 1

Question: Is there a reliable model to predict intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD)?
Finding: We constructed 5 machine learning models to predict IVIG-resistant KD. Extreme gradient boosting (XGBoost) model was superior to logistic, support vector machine, light gradient boosting machine and multiple layers perception models. The SHAP (SHapley Additive exPlanations) value interpreted the contribution of each feature in XGBoost model.
Meaning: XGBoost model showed the excellent performance to predict IVIG-resistant KD with explainable and visualizable machine learning algorithm.

DOI: https://doi.org/10.3345/cep.2024.00549

Developmental and Behavioral Medicine

Neonatal risk factors associated with autism spectrum disorders: an umbrella review

Amir Mohammad Salehi, Erfan Ayubi, Salman Khazaei, Ensiyeh Jenabi, Saeid Bashirian, Zohreh Salimi

Clin Exp Pediatr. 2024;67(9):459-464. Published online July 19, 2024

Question: What are the neonatal risk factors for autism spectrum disorder (ASD)?
Findings: Significant effect sizes were observed for congenital heart disease (odds ratio [OR], 1.35), macrosomia (OR, 1.11), low birth weight (OR, 1.63), very low birth weight (OR, 2.25), small for gestational age (OR, 1.17), jaundice (OR, 1.74), male sex (OR, 1.47), and Apgar score (OR, 1.40).
Meaning: These factors were identified as risk factors for ASD.

DOI: https://doi.org/10.3345/cep.2024.00136

Review Article

Neonatology (Perinatology)

Demographic transition in South Korea: implications of falling birth rates

Chae Young Kim, Sung-Hoon Chung

Clin Exp Pediatr. 2024;67(10):498-509. Published online June 27, 2024

Web of Science 2 Crossref 1

· Since 1960, South Korea's TFR decreased from 6.33 to 0.78 in 2022, below the 2.1 replacement level since 1983, with women's average age at first marriage rising to 31.3 in 2022.
· Policies needed: financial incentives, longer parental leave, better childcare.
· The U.S. (15.3% immigrants) and Germany (18.8%) use immigration to maintain demographic stability, a strategy South Korea is considering.

DOI: https://doi.org/10.3345/cep.2023.01599

Endocrinology

Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis

Maya L. Nasser, Joseph Nasr, Reem B. Zalloum, Nathanael Q.E. Yap, Natalie E. Bourdakos, Shahid Miangul, Tara A. Betts, Hayato Nakanishi, Christian A. Than, Serge Jabbour

Clin Exp Pediatr. 2024;67(10):486-497. Published online June 27, 2024

· The safety and efficacy of the two-bag versus one-bag system for treating patients with diabetic ketoacidosis (DKA) < 21 years remains unestablished.
· Our meta-analysis demonstrated similar safety outcomes but sooner DKA resolution and shorter mean response time for intravenous fluid changes for the two-bag system.
· This preliminary evidence suggests that the two-bag system has some advantages in efficacy, but further studies are needed to evaluate their extent.

DOI: https://doi.org/10.3345/cep.2023.01536

Original Article

Nutrition

Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach

Ratu Ayu Dewi Sartika, Fadila Wirawan, Wawan Gunawan, Primasti Nuryandari Putri, Nurul Husna Mohd Shukri

Clin Exp Pediatr. 2024;67(7):358-367. Published online June 21, 2024

Question: Does paternal support affect exclusive breastfeeding failure?
Finding: Exclusive breastfeeding failure by 3 months was affected by paternal support.
Meaning: Fathers should be included in breastfeeding education and antenatal care.

DOI: https://doi.org/10.3345/cep.2023.01375

Letter to the Editor

Developmental and Behavioral Medicine

Efficacy of social skills group intervention among children with mild autism spectrum disorder

Lee Ling Low, Ker Yang Chua, Bih Hwa Ching

Clin Exp Pediatr. 2024;67(7):368-370. Published online May 31, 2024

DOI: https://doi.org/10.3345/cep.2024.00122

Review Article

Developmental and Behavioral Medicine

Comprehensive evaluation of the child with global developmental delays or intellectual disability

Abdullah Nasser Aldosari, T. Saeed Aldosari

Clin Exp Pediatr. 2024;67(9):435-446. Published online May 29, 2024

· A detailed history and comprehensive physical examination remain the cornerstones for establishing a diagnosis of global developmental delay/intellectual disability (GDD/ID).
· Comprehensive surveillance and screening programs play a significant role in the early detection of GDD.
· Whole-exome sequencing is highly recommended as first- or second-line testing for individuals with idiopathic GDD/ID.
· Early intervention by a well-versed multidisciplinary team can significantly improve the outcomes and prognosis of GDD/ID.

DOI: https://doi.org/10.3345/cep.2023.01697

Letter to the Editor

Neonatology (Perinatology)

Pentraxin 3 as a marker of early-onset neonatal sepsis

Safaa ELMeneza, Iman El-Bagoury, Hind Rayes, Amira Hassan

Clin Exp Pediatr. 2024;67(6):312-314. Published online May 23, 2024

DOI: https://doi.org/10.3345/cep.2024.00409

Original Article

Developmental and Behavioral Medicine

Effectiveness of online responsive teaching in young children with developmental disabilities: a pilot study

Jung Sook Yeom, Jeongmee Kim

Clin Exp Pediatr. 2024;67(6):303-311. Published online May 21, 2024

Crossref 1

Question: Does online responsive teaching (RT) impact children's and parents’ emotions and behaviors, and do parents find it satisfactory?
Finding: Online RT significantly improved children's pivotal and problem behaviors, decreased parenting stress, and enhanced parental interactive styles with high satisfaction.
Meaning: This pilot study's findings suggest that online RT can enhance child outcomes, offering accessible interventions amid challenges such as limited access and pandemics.

DOI: https://doi.org/10.3345/cep.2023.01662

Endocrinology

Kisspeptin and DLK1 levels for monitoring treatment of girls with central precocious puberty

Witchuwan Onsoi, Nattakarn Numsriskulrat, Suphab Aroonparkmongkol, Vichit Supornsilchai, Khomsak Srilanchakon

Clin Exp Pediatr. 2024;67(6):296-302. Published online May 21, 2024

Web of Science 2 Crossref 3

Questions: Can the serum levels of kisspeptin and DLK1 be potential biomarkers for monitoring the treatments for central precocious puberty (CPP)?
Findings: There were no significant differences in the baseline serum kisspeptin and DLK1 levels in CPP girls compared to girls with premature thelarche (PT). After 6 months of GnRH analogue treatment in CPP girls, median serum kisspeptin levels decreased, while median serum DLK1 levels increased compared to baseline.
Meanings: Serum levels of kisspeptin and DLK1 may serve as novel biomarkers for monitoring the efficacy of treatments for CPP.

DOI: https://doi.org/10.3345/cep.2023.01361

Cited By 21	Neurodevelopmental outcomes of preterm infants
Cited By 19	Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Cited By 17	Association of gut microbiota with obesity in children and adolescents
Cited By 16	Nonalcoholic fatty liver disease and insulin resistance in children
Cited By 16	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis

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