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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
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.
Review Article
Immunology
Systemic autoinflammatory disorders
Dae Chul Jeong
Clin Exp Pediatr. 2023;66(10):432-438.   Published online June 14, 2023
· 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.
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
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
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.
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
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.
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
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
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.
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
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.
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
· 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.
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.
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
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.
Editorial
Gastroenterology
Gut microbiota’s impact on obesity
Sujin Jeong
Clin Exp Pediatr. 2023;66(7):294-295.   Published online June 14, 2023
· 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.
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
· 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.
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
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.
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
· 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.
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
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
· 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.
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.
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
· 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.
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
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.
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
· 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.
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.
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
· 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.
Infection
COVID-19 in immunocompromised children and adolescents
Byung Ok Kwak, Byung Wook Eun
Clin Exp Pediatr. 2023;66(5):182-189.   Published online April 18, 2023
Most immunocompromised children and adolescents are not at increased risk of developing severe coronavirus disease 2019 (COVID-19). COVID-19 outcomes for low- or medium-risk immunocompromised children are favorable, while more serious illness reportedly occurs in high-risk immunocompromised children by underlying disease, its treatments, and other factors. Therefore, the early detection and timely management of severe COVID-19 and treatment of underlying disease are important. Hospitalization and COVID-19 vaccination should be carefully considered.
Perspective
Other
New public-centered child protection system in Korea
We Sun Shim
Clin Exp Pediatr. 2023;66(5):179-181.   Published online April 18, 2023
Korea’s child abuse response system was transformed under policy change in April 2020, from what was previously operated on a private-centered basis to a focus on the public sector with expanded role of local governments. Promising outcomes are expected with new system as greater governmental intervention will effectively protect at-risk children with acceleration in institutional collaboration and expertise in information management and administration.
Editorial
Other
Advancing pediatric health: the multifaceted scope of Clinical and Experimental Pediatrics
Jin Hee Oh, Man Yong Han
Clin Exp Pediatr. 2023;66(4):171-172.   Published online March 29, 2023
Clinical and Experimental Pediatrics (CEP) is a journal that specializes in pediatric research topics. It covers a wide range of research areas, including basic research, translational research, and research related to improving pediatric health and diseases. CEP also focuses on the coordination of societal structures and processes that orchestrate pediatric health and disease throughout society, and the parallel relationship between regional characteristics and globalization. The journal intends to continue promoting pediatric health through relentless efforts and the discovery of new research areas.
Clinical Note
Other
Novel PTRH2 gene variant causing IMNEPD (infantile-onset multisystem neurologic, endocrine, and pancreatic disease) in 2 Saudi siblings
Dalal K. Bubshait
Clin Exp Pediatr. 2023;66(5):223-225.   Published online March 23, 2023
Editorial
Gastroenterology
Is there a link between social media usage and functional gastrointestinal disorders in children?
Hae Jeong Lee
Clin Exp Pediatr. 2023;66(4):169-170.   Published online March 23, 2023
Social media use has potential benefits and risks, including links to adverse health problems in children such as functional gastrointestinal disorders (FGIDs). Screen time control, emotional support, and parental guidance can help children navigate social media safely and reduce the risk of developing FGIDs.
Original Article
Hematology
Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia
Fady Mohamed El-Gendy, Amira M.F. Shehata, Esam Awad Abd El-Kawy, Mahmoud Ahmed El-Hawy
Clin Exp Pediatr. 2023;66(3):127-133.   Published online February 24, 2023
Question: What are the PD-1+ CD4+ T cells percentages and serum interferon gamma (IFN-γ) levels of pediatric patients with immune thrombocytopenia (ITP)?
Finding: Compared with healthy controls, the PD-1+ CD4+ T cells percentages and IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy.
Meaning: Our findings suggest that PD-1+ CD4+ T cells and IFN-γ are involved in the pathophysiological process of ITP.
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