Clinical and Experimental Pediatrics

Review Article

Gastroenterology

High-resolution anorectal manometry in children

Yogesh Waikar

Clin Exp Pediatr. 2024;67(2):57-63. Published online June 14, 2023

· Anorectal manometry is safe in children.
· Defecation Dyssynergia is one of the commonest cause of chronic constipation.
· Positive Rectoanal inhibiory reflex rules out Hirschsprung's Disease

DOI: https://doi.org/10.3345/cep.2022.01242

Developmental and Behavioral Medicine

Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates

Tae Hoon Eom, Young-Hoon Kim

Clin Exp Pediatr. 2024;67(1):26-34. Published online June 14, 2023

Web of Science 6 Crossref 7

· Primary pediatricians should play a key role in the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD).
· The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has lowered the diagnostic threshold for older teens and adults and a comorbid diagnosis with autism is now allowed.
· The American Academy of Pediatrics had added recommendation-related comorbid conditions in its guideline and the Society of Developmental and Behavioral Pediatrics recently developed a complex ADHD guideline.
· The European ADHD Guideline Group recently developed a guideline for managing ADHD during the coronavirus disease 2019 pandemic.

DOI: https://doi.org/10.3345/cep.2021.01466

Nephrology (Genitourinary)

X-linked hypophosphatemic rickets: from diagnosis to management

Eujin Park, Hee Gyung Kang

Clin Exp Pediatr. 2024;67(1):17-25. Published online June 14, 2023

Web of Science 1 Crossref 1

· X-linked hypophosphatemia (XLH), the most common cause of hypophosphatemic rickets, affects 1/20,000 people.
· XLH is caused by a loss-of-function mutation of the PHEX gene.
· Its main pathogenesis is elevated fibroblast growth factor-23 (FGF23) level.
· Burosumab, an FGF23 inhibitor, was developed in the early 2000s.
· Burosumab was approved in Korea in 2020 for XLH patients aged 1+ years with radiographic evidence of bone disease.

DOI: https://doi.org/10.3345/cep.2022.01459

Original Article

General Pediatrics

Virtual reality for pain reduction during intravenous injection in pediatrics: a systematic review and meta-analysis of controlled clinical trials

Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Masoud Rafiee, Mozhdeh Bashirian

Clin Exp Pediatr. 2023;66(12):533-537. Published online June 14, 2023

Web of Science 3 Crossref 4

Question: This is the first meta-analysis to examine published evidence of the effectiveness of virtual reality at reducing pain during pediatric intravenous injections.
Finding: Our results suggest that virtual reality effectively reduces pain associated with intravenous injections in pediatric patients.
Meaning: These findings suggest the importance of virtual reality in decreasing the pain of intravenous injections among children.

DOI: https://doi.org/10.3345/cep.2022.01193

Review Article

Endocrinology

Applications of genomic research in pediatric endocrine diseases

Ja Hye Kim, Jin-Ho Choi

Clin Exp Pediatr. 2023;66(12):520-530. Published online June 14, 2023

Web of Science 1 Crossref 1

· Recent advances in molecular genetics have improved our understanding of pediatric endocrine disorders and are now used in mainstream medical practice.
· Genome-wide association studies can increase our understanding of the biological mechanisms of disease and inform new therapeutic options.
· The identification of founder mutations leads to the efficient localization of the genes underlying Mendelian disorders.
· Next-generation sequencing technologies benefit clinical practice and research of pediatric endocrinology.

DOI: https://doi.org/10.3345/cep.2022.00948

Allergy

Natural course of IgE-mediated food allergy in children

Kyunguk Jeong, Sooyoung Lee

Clin Exp Pediatr. 2023;66(12):504-511. Published online June 14, 2023

Web of Science 10 Crossref 13

· Dendritic, regulatory T, and regulatory B cells significantly contribute to the natural course of food allergy.
· Cow’s milk and hen’s egg allergies tend to resolve in earlier childhood but recent studies show that 50% of patients still persist into school age.
· The potential factors affecting the natural course of food allergy are age at diagnosis, symptom severity, sensitization status and its change rate, and external factors such as diet and interventions.
· There is a considerable possibility of food allergy outgrow if specific IgE levels are 2–5 kUA/L or less, but other factors such as age and recent symptoms should be considered together.
· With a clear understanding of the natural course of food allergy, pediatricians can provide appropriate assessment and interventions to our patients, and consequently can help patients overcome their food allergy and improve the social safety net.

DOI: https://doi.org/10.3345/cep.2022.01004

Original Article

Gastroenterology

Inferior vena cava to aorta ratio in dehydrated pediatric patients: a systematic review and meta-analysis

Gilbert Sterling Octavius, Michelle Imanuelly, Johan Wibowo, Nadia Khoirunnisa Heryadi, Melanie Widjaja

Clin Exp Pediatr. 2023;66(11):477-484. Published online June 14, 2023

Web of Science 2 Crossref 2

Question: The inferior vena cava to aorta (IVC/Ao) ratio measured via ultrasound has been touted as a promising noninvasive technique to assess clinically significant dehydration in pediatric patients.
Finding: Our meta-analysis found that IVC/Ao ratio had a positive likelihood ratio of 3.2 (95% confidence interval [CI], 2.1–5.1) and negative likelihood ratio of 0.18 (95% CI, 0.12–0.28).
Meaning: Hence, IVC/Ao ratio is insufficient to exclude or confirm significant dehydration in pediatric patients.

DOI: https://doi.org/10.3345/cep.2022.01445

Review Article

Immunology

Systemic autoinflammatory disorders

Dae Chul Jeong

Clin Exp Pediatr. 2023;66(10):432-438. Published online June 14, 2023

Web of Science 4 Crossref 5

· Systemic autoinflammatory disorders (SAID) are disorders caused by dysregulation of the innate immunity with genetic background, leading to recurrent episodes of systemic inflammation.
· SAID is characterized by recurrent acute inflammatory responses including fever or skin manifestations, unrelated with infection or malignancy.
· Diagnosis is based on family and long-term history with detailed clinical and laboratory manifestations during febrile periods.

DOI: https://doi.org/10.3345/cep.2022.01186

Correspondence

Cardiology

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

Seyedeh Mahdieh Namayandeh, Nastran Ahmadi, Seyed Mahmood Sadr

Clin Exp Pediatr. 2023;66(9):414-414. Published online June 14, 2023

DOI: https://doi.org/10.3345/cep.2021.01312

Original Article

Critical Care Medicine

Timing of parenteral nutrition initiation in critically ill children: a randomized clinical trial

Nagwan Y. Saleh, Hesham M. Aboelghar, Nehad B. Abdelaty, Mohamed I. Garib, Asmaa A. Mahmoud

Clin Exp Pediatr. 2023;66(9):403-411. Published online June 14, 2023

Web of Science 3 Crossref 4

Question: What is the ideal initiation timing of parenteral nutrition for critically ill children?
Finding: This randomized clinical trial of 140 children examined the effects of an early or late start of parenteral nutrition on mechanical ventilation need (primary outcome) and length of stay and mortality (secondary outcomes).
Meaning: Children who received early versus late parenteral nutrition had lower mechanical ventilation need and duration.

DOI: https://doi.org/10.3345/cep.2023.00178

Gastroenterology

Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome

Ozlem Kara, Hanife Aysegul Arsoy, Murat Keskin

Clin Exp Pediatr. 2023;66(9):395-402. Published online June 14, 2023

Web of Science 6 Crossref 4

Question: Is polycystic ovary syndrome (PCOS) a risk factor for nonalcoholic fatty liver disease (NAFLD) in adolescents?
Finding: The frequency of NAFLD did not increase in adolescents with PCOS. However, hyperandrogenemia was a risk factor for NAFLD.
Meaning: Adolescents with PCOS and hyperandrogenemia should be closely monitored for hepatic steatosis.

DOI: https://doi.org/10.3345/cep.2023.00353

Letter to the Editor

Infection

SARS-CoV-2 fecal shedding pattern in pediatric patients with acute COVID-19 or COVID-19-associated multisystem inflammatory syndrome

Setareh Mamishi, Fatemeh Jalali, Sepideh Benvari, Babak Pourakbari, Mohammad Reza Abdolsalehi, Reihaneh Hosseinpour Sadeghi, Mohammad Shahbabaie, Amene Navaeian, Shima Mahmoudi

Clin Exp Pediatr. 2023;66(8):366-368. Published online June 14, 2023

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2023.00297

Original Article

Allergy

Association between dyslipidemia and asthma in children: a systematic review and multicenter cohort study using a common data model

Ji Eun Lim, Hye Min Kim, Ju Hee Kim, Hey Sung Baek, Man Yong Han

Clin Exp Pediatr. 2023;66(8):357-365. Published online June 14, 2023

Web of Science 7 Crossref 7

Question: Is dyslipidemia a risk factor for asthma in children?
Finding: This was a comprehensive systematic review and retrospective multicenter study of the association between dyslipidemia and asthma in children. In a multicenter cohort analysis using the Observational Medical Outcomes Partnership Common Data Model, elevated total cholesterol levels were associated with increased risk of asthma development.
Meaning: These findings suggest an association between dyslipidemia and asthma in children.

DOI: https://doi.org/10.3345/cep.2023.00290

Neurology

Need for palliative care from birth to infancy in pediatric patients with neurological diseases

Raffaele Falsaperla, Silvia Marino, Carla Moscheo, Lucia Giovanna Tardino, Simona Domenica Marino, Concetta Sciuto, Piero Pavone, Giovanna Vitaliti, Federica Sullo, Martino Ruggieri

Clin Exp Pediatr. 2023;66(8):350-356. Published online June 14, 2023

Web of Science 2 Crossref 2

Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy?
Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis.
Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required.

DOI: https://doi.org/10.3345/cep.2023.00129

Editorial

Cardiology

Arrhythmias in pediatric patients with COVID-19

Ji-Eun Ban

Clin Exp Pediatr. 2023;66(8):348-349. Published online June 14, 2023

Web of Science 1 Crossref 1

· Childrens with coronavirus disease 2019 less commonly display life-threatening arrhythmias, including premature atrial or ventricular beats, or conduction disturbances such as first-degree atrioventricular blocks.
· Life-threatening arrhythmias (e.g., nonsustained or sustained ventricular tachycardia, atrial tachycardia, atrial fibrillation, complete atrioventricular block) occur in children with sudden acute respiratory syndrome coronavirus-2 infection suffering from myocarditis or multisystem inflammatory syndrome in children (MIS-C).
· Monitoring clinical status and assessing and managing arrhythmias are crucial in MIS-C.

DOI: https://doi.org/10.3345/cep.2023.00584

Review Article

Allergy

Trends of vitamin D in asthma in the pediatric population for two decades: a systematic review

Myongsoon Sung

Clin Exp Pediatr. 2023;66(8):339-347. Published online June 14, 2023

· Vitamin D may affect asthma via multiple mechanisms, including lung and optimal immune system functions.
· Many clinical trials have demonstrated the beneficial effects of vitamin D on asthma onset and aggravation. However, definitive clinical trials are lacking, and reports have detailed contradictory effects of vitamin D in children with asthma.
· Some exciting reports stated that obesity and vitamin D deficiency are associated with increased asthma symptoms in the pediatric population.

DOI: https://doi.org/10.3345/cep.2022.01109

Original Article

Gastroenterology

Assessing indicators and clinical differences between functional and organic childhood constipation: a retrospective study in pediatric gastroenterology clinics

Hasan M. Isa, Fatema A. Alkharsi, Fatema A. Salman, Maryam S. Ali, Zahra K. Abdulnabibi, Afaf M. Mohamed

Clin Exp Pediatr. 2023;66(7):296-306. Published online June 14, 2023

Crossref 1

Question: What causes childhood constipation, and what can predict organic constipation?
Finding: Constipation represents 14.7% of gastroenterology visits. Functional constipation is more common among constipation types, while organic constipation is more common in young children and those with a low body weight, stunted growth, mucus in the stool, and associated diseases.
Meaning: Younger children and those with lower growth or mucus in the stool should be assessed for underlying organic causes of constipation.

DOI: https://doi.org/10.3345/cep.2022.01298

Editorial

Gastroenterology

Gut microbiota’s impact on obesity

Sujin Jeong

Clin Exp Pediatr. 2023;66(7):294-295. Published online June 14, 2023

Web of Science 1 Crossref 1

· An imbalance of the gut microbiota with a relative increase in Firmicutes versus Bacteroidetes is associated with the pathogenesis of obesity.
· Dysbiosis is associated with microbial genes associated with short-chain fatty acids (SCFA) production and increased colonic SCFA levels. SCFAs have also been shown to regulate appetite and satiety hormones, which can affect food intake and energy balance.
· A dietary high-fat intake is reportedly associated with increased plasma lipopolysaccharide. Altered Toll-like receptor-4 signaling leads to propagating the cascade of further inflammation and promoting insulin resistance.

DOI: https://doi.org/10.3345/cep.2023.00458

Review Article

Infection

Safety monitoring of COVID-19 vaccines: February 26, 2021, To June 4, 2022, Republic of Korea

Yeon-Kyeng Lee, Yunhyung Kwon, Yesul Heo, Eun Kyoung Kim, Seung Yun Kim, Hoon Cho, Seontae Kim, Mijeong Ko, Dosang Lim, Soon-Young Seo, Enhi Cho

Clin Exp Pediatr. 2023;66(10):415-423. Published online June 13, 2023

Web of Science 2 Crossref 2

· Enhanced safety monitoring system of coronavirus disease 2019 (COVID-19) vaccines were implemented to detect signals rapidly as part of the national COVID-19 vaccination program.
· As of June 4, 2023, reported adverse events after COVID-19 vaccination was 0.38% among 125,107,883 doses of COVID- 19 vaccines administered.
· Most reported adverse reactions after COVID-19 vaccinations have shown nonserious and mild intensity.

DOI: https://doi.org/10.3345/cep.2022.00815

Other

MicroRNAs as novel biomarkers for the diagnosis and treatment of pediatric diseases

Hwal Rim Jeong, Il Tae Hwang

Clin Exp Pediatr. 2024;67(3):119-125. Published online May 24, 2023

Web of Science 5 Crossref 3

MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression post transcriptionally, and MiRNA expression levels vary with developmental stages. MiRNAs play an important role in several biological processes in children, including growth, neuro-development, inflammation, and tumor formation. Research on miRNAs may uncover the molecular mechanisms underlying various pediatric diseases, leading to the development of novel biomarkers that aid in the diagnosis, treatment, and prognosis of these diseases.

DOI: https://doi.org/10.3345/cep.2023.00171

Original Article

Other

Virtual, augmented, and mixed reality: potential clinical and training applications in pediatrics

Suyoung Yoo, Meong Hi Son

Clin Exp Pediatr. 2024;67(2):92-103. Published online May 24, 2023

Web of Science 1 Crossref 2

· Review of articles that investigated the applications of virtual, augmented, or mixed reality in pediatric clinical settings and in the training of pediatric medical professionals was conducted.
· A total of 89 studies were retrieved, with 36 randomized controlled trials.
· In most studies, intervention using the novel technology was at least as effective or more effective than the traditional method.
· Use of virtual, augmented, and mixed reality has potential in pediatrics.

DOI: https://doi.org/10.3345/cep.2022.00731

Letter to the Editor

Developmental and Behavioral Medicine

Effect of rolling over pattern and caregiver perception on plagiocephaly in Korean infants

Jin A Yoon, Soo-Yeon Kim, Yong Beom Shin

Clin Exp Pediatr. 2023;66(6):272-273. Published online May 24, 2023

Web of Science 2 Crossref 2

DOI: https://doi.org/10.3345/cep.2023.00108

Original Article

Developmental and Behavioral Medicine

Parenting stress and interactive engagement behaviors in children with developmental delay

Jung Sook Yeom, Rock Bum Kim, Jae Young Cho, Ji Sook Park, Eun Sil Park, Ji-Hyun Seo, Jae-Young Lim, Hyang-Ok Woo

Clin Exp Pediatr. 2023;66(6):252-261. Published online May 19, 2023

Web of Science 1 Crossref 1

· Question: What level of parenting stress is experienced by parents of children with developmental delays (DDs) without autism spectrum disorder, and what factors contribute to it?
· Findings: Parents of children with DDs experienced high parenting stress that were significantly mediated by their children’s low interactive behaviors.
· Meaning: The interactive behaviors of children with DDs mediate parenting stress.

DOI: https://doi.org/10.3345/cep.2023.00101

Editorial

Gastroenterology

Recent advances in epigenetic mechanisms, diagnosis, and treatment of pediatric gastrointestinal allergic disorders

Eell Ryoo

Clin Exp Pediatr. 2023;66(6):250-251. Published online May 19, 2023

· Epigenetic mechanisms are involved in rapidly increasing food allergy.
· There is still no definitive way to diagnose food allergy.
· Early introduction of peanuts, eggs, and cow’s milk reduces food allergy incidence.
· Administration of probiotics such as Lactobacillus rhamnosus GG, Bifidobacterium bifidum can partially reduce the occurrence of allergic symptoms.

DOI: https://doi.org/10.3345/cep.2023.00136

Review Article

Developmental and Behavioral Medicine

Spontaneous movements as prognostic tool of neurodevelopmental outcomes in preterm infants: a narrative review

Hyun Iee Shin, Myung Woo Park, Woo Hyung Lee

Clin Exp Pediatr. 2023;66(11):458-464. Published online May 16, 2023

Web of Science 2 Crossref 2

· Spontaneous movements can be useful to evaluate neuronal integrity in preterm infants.
· In General Movements Assessment, continuous cramped synchronized movements and absent fidgety movements can indicate high-risk infants for cerebral palsy.
· Recent advances in machine learning techniques have led to the automated prediction of cerebral palsy based on infantile spontaneous movements.

DOI: https://doi.org/10.3345/cep.2022.01235

Letter to the Editor

Infection

Chest x-ray findings in children with COVID-19: lesson learned from referral hospitals in Medan, North Sumatera, Indonesia

Andrew Limavady, Eka Airlangga, Ririe Fachrina Malisie, Ayodhia Pitaloka Pasaribu

Clin Exp Pediatr. 2023;66(7):317-319. Published online May 16, 2023

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2022.01179

Original Article

Cardiology

Echocardiographic reference z scores of right ventricular dimension and systolic function of children aged 5–12 years

Alaba Busola Oladimeji, Moriam Omolola Lamina, Peter Odion Ubuane, Motunrayo Oluwabukola Adekunle, Omolara Adeolu Kehinde, Barakat Adeola Animasahun, Olisamedua FidelisNjokanma

Clin Exp Pediatr. 2023;66(5):215-222. Published online April 18, 2023

Question: Z score reference values for right ventricular size and systolic function in children using echocardiography are available in several countries. Despite the high burden of diseases involving the right ventricle in Nigeria, these reference values have limited applicability.
Finding: The right ventricular sizes of Nigerian children differed from those published elsewhere.
Meaning: These reference values will aid the treatment, monitoring, and pre- and postintervention for Nigerian children.

DOI: https://doi.org/10.3345/cep.2022.01410

Editorial

Infection

Impact and role of vitamins as immunonutrition in children during COVID-19 pandemic

Yoo Min Lee

Clin Exp Pediatr. 2023;66(5):212-214. Published online April 18, 2023

Crossref 1

· Vitamins have effector mechanisms in the innate and adaptive immune systems and potential roles in preventing and reducing the severity of coronavirus disease 2019 (COVID-19).
· Vitamins may be immunonutrients in the treatment of COVID-19 infections and prevention of patient deterioration due to critical illness, thus demonstrating the significance of a nutritious, well-balanced diet.

DOI: https://doi.org/10.3345/cep.2022.01305

Neurology

Understanding the usefulness of electroencephalography source localization

Bo Lyun Lee

Clin Exp Pediatr. 2023;66(5):210-211. Published online April 18, 2023

· Electroencephalography (EEG) records brain activity with high temporal resolution.
· EEG source localization, combined with other functional or structural imaging methods, provides information about brain network and connectivity in clinical neuroscience.
· EEG source localization identifies brain location from electrical current sources in several neuropsychiatric diseases such as epilepsy, attention deficit/hyperactivity disorder, and anxiety disorders.

DOI: https://doi.org/10.3345/cep.2022.01480

Review Article

Cardiology

Arrhythmia and COVID-19 in children

Mi Kyoung Song, Bryan Kwon

Clin Exp Pediatr. 2023;66(5):190-200. Published online April 18, 2023

Web of Science 4 Crossref 5

· Pediatric patients have a relatively low incidence of tachyarrhythmia both in acute coronavirus disease 2019 and multisystem inflammatory syndrome in children (MIS-C), but it was associated with an increased risk of poor outcomes.
· Conduction abnormalities were not uncommon, especially in those with MIS-C. Most patients recovered to normal sinus rhythm; however, some progressed to advanced atrioventricular block and rarely required permanent pacemaker implantation.

DOI: https://doi.org/10.3345/cep.2023.00024

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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