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Editorial
Nephrology (Genitourinary)
Optimal hemodialysis treatment for pediatric kidney failure patients
Yo Han Ahn
Clin Exp Pediatr. 2023;66(3):125-126.   Published online February 15, 2023
· Although the basic concept of hemodialysis (HD) is similar in adults and children, specific factors must be considered in the latter, including the small dialyzer and circuit, difficult vascular access, and frequent complications.
· HD-associated complications include catheter-related problems, hemodynamic instability, and neurodevelopmental and cognitive dysfunction.
· Pediatric HD is challenging, and steady efforts are needed to perform it safely and reduce its complications, thereby improving clinical outcomes.
Review Article
Neurology
Pediatric syncope: pearls and pitfalls in history taking
Jung Sook Yeom, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(3):88-97.   Published online February 15, 2023
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.
Letter to the Editor
Endocrinology
Accuracy of predicted adult height using the Greulich-Pyle method and artificial intelligence medical device
Dongho Cho, Yun Sun Choi, Hayun Oh, Young min Ahn, Ji-Young Seo
Clin Exp Pediatr. 2023;66(3):145-147.   Published online January 25, 2023
Review Article
Infection
Pathogenetic and etiologic considerations of febrile seizures
Ji Yoon Han, Seung Beom Han
Clin Exp Pediatr. 2023;66(2):46-53.   Published online January 13, 2023
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.
Endocrinology
Nonalcoholic fatty liver disease and insulin resistance in children
Kyungchul Song, Ho-Seong Kim, Hyun Wook Chae
Clin Exp Pediatr. 2023;66(12):512-519.   Published online January 9, 2023
· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea.
· Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD.
· Insulin resistance is closely related to NAFLD.
Other
Hearing loss in neonates and infants
Goun Choe, Su-Kyoung Park, Bong Jik Kim
Clin Exp Pediatr. 2023;66(9):369-376.   Published online January 9, 2023
· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates.
· Etiologies vary, and up to 80% of cases are genetic.
· Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention.
Allergy
Recent topics on gastrointestinal allergic disorders
Yoshiyuki Yamada
Clin Exp Pediatr. 2023;66(6):240-249.   Published online January 9, 2023
Gastrointestinal (GI) allergies are divided into immunoglobulin E (IgE)-mediated, non-IgE-mediated, and mixed types. In addition to non-IgE-mediated, overlapping eosinophilic GI disorders (EGIDs) have increased in Japan. EGIDs, a mixed-type allergy category, include eosinophilic esophagitis (EoE) and non-EoE EGIDs. The number of EoE cases has increased in Western countries, followed by Asian countries. Recent GI allergies may also be associated with type 2 inflammation.
Gastroenterology
Update on eosinophilic gastrointestinal disease beyond eosinophilic esophagitis in children
Hye Ran Yang
Clin Exp Pediatr. 2023;66(6):233-239.   Published online January 3, 2023
· Eosinophilic gastrointestinal disease (EGID) is uncommon, with a prevalence of 1–30/100,000 in the general population; however, it is increasing worldwide.
· The diagnosis of EGID is based on histopathological findings of endoscopic mucosal biopsy in which tissue eosinophils are counted in each gastrointestinal tract segment of patients with chronic or recurrent gastrointestinal symptoms.
· Individualized treatment strategies, including adequate dietary and pharmacological therapy, may help improve outcomes of children with EGID.
Cardiology
Environmental changes surrounding congenital heart disease
Eun-Young Choi
Clin Exp Pediatr. 2023;66(8):332-338.   Published online January 2, 2023
· As the number of patients with congenital heart disease increases, the medical burden increases.
· Various fusion imaging techniques using percutaneous procedures have been introduced.
· With advances in technology, convenient ambulatory devices have been introduced.
· A well-organized team approach is required to resolve advanced heart failure in patients with congenital heart disease.
Neonatology (Perinatology)
Neurodevelopmental outcomes of preterm infants
In Gyu Song
Clin Exp Pediatr. 2023;66(7):281-287.   Published online December 30, 2022
· Among survivors, 60.9% of infants born at 22 weeks’ gestation had moderate to severe impairments, whereas 50.3% born at 23 weeks’ and 42.2% at 24 weeks’ gestation had moderate to severe impairments.
· Moderate and late preterm infants reportedly have less severe disease than very preterm infants, but they still experience adverse neurodevelopmental outcomes.
· The careful follow-up and early detection of developmental problems in these patients are required.
Clinical Note
Genetics and Metabolism
Biallelic POLR3A variants cause Wiedemann-Rautenstrauch syndrome with atypical brain involvement
Byungseung Moon, Minhye Kim, Hye Jin Kim, Jae So Cho, Hey Joon Son, Byung Chan Lim, Ki Joong Kim, Jong Hee Chae, Soo Yeon Kim
Clin Exp Pediatr. 2023;66(3):142-144.   Published online December 30, 2022
Review Article
Neurology
Electroencephalography source localization
Tae-Hoon Eom
Clin Exp Pediatr. 2023;66(5):201-209.   Published online December 29, 2022
· Electroencephalography (EEG) directly images the electrical activity of neurons at a higher temporal resolution than other neuroimaging techniques.
· EEG is still widely used in brain function research due to its advantages.
· Forward and inverse problems of EEG analyses require solutions.
· Methods such as the dipole and distributed source models have been introduced.
· Applications of EEG are expanding with the integration of other technologies and large-scale data.
Neonatology (Perinatology)
Treatment of congenital cytomegalovirus infection
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(9):384-394.   Published online December 28, 2022
· Congenital cytomegalovirus (CMV) infection is among the most common causes of nongenetic sensorineural hearing loss.
· Congenital CMV is initially treated with intravenous ganciclovir for 2–6 weeks and switched to oral valganciclovir, or with oral valganciclovir for the entire 6-month period.
· Infants with congenital CMV require periodic monitoring of absolute neutrophil count, platelet count, and blood urea nitrogen, creatinine, liver function tests, audiological, ophthalmological, and developmental tests during antiviral medication.
Original Article
Infection
Seroprevalence of maternal peripartum human T-cell lymphotropic virus type-1 infection: a systematic review and meta-analysis of the Nigerian literature
Abdulrasheed Usman, Muhammad Hamis Musa, Bukhari Isah Shuaib, Olayemi Balogun, Mukhtar Adeiza
Clin Exp Pediatr. 2023;66(7):307-316.   Published online December 22, 2022
The peripartum period is an important transmission time for human T-cell lymphotropic virus-1 (HTLV-1) infection, mainly via breastfeeding and partly through the placental tissues of carrier mothers. Although most HTLV-1–infected individuals are asymptomatic, fetal and childhood infections often result in several diseases with disappointing treatment outcomes. An estimated HTLV-1 burden in Nigeria among perinatal women must be determined to enable rational planning of a comprehensive health care intervention.
Review Article
General Pediatrics
Korean Developmental Screening Test for Infants and Children (K-DST): development, applications, and implications for future early childhood development interventions
Dooyoung Kim, Young June Choe, Bilal Aurang Zeb Durrani, EunYoung Kim, Junghye Byeon, Baik-Lin Eun
Clin Exp Pediatr. 2023;66(7):288-293.   Published online December 22, 2022
· This review discusses the development and application of the Korean Developmental Screening Test for Infants and Children (K-DST) for ensuring early childhood development.
· Various studies have demonstrated the integral role of the K-DST in facilitating the detection of developmental delays and delivery of timely interventions.
· The tailoring of the K-DST to Korean infants and children suggests that other countries may further translate and adapt it.
Original Article
Infection
Predicting COVID-19 transmission in a student population in Seoul, South Korea, 2020–2021
Young Hwa Lee, Han Ho Kim, Young June Choe
Clin Exp Pediatr. 2023;66(4):173-178.   Published online December 22, 2022
Question: What is the spatial distribution and determinants of coronavirus disease 2019 (COVID-19) infection among students in Korea?
Finding: The community population was closely associated with the risk of COVID-19, and the number of students per school class were inversely associated with COVID-19 rates in students.
Meaning: Our finding suggests that controlling the community-level burden of COVID-19 can help prevent sudden acute respiratory syndrome coronavirus 2 infection in school-aged children.
Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study
In Suk Sol, Eun Lee, Hyeon-Jong Yang, Yong Ju Lee, Hye Yung Yum, Mi-Hee Lee, Mi Ae Chu, Hui Jeong Moon, Hyo-Bin Kim, Ju Hee Seo, Jung Yeon Shim, Ji Young Ahn, Yoon Young Jang, Hai Lee Chung, Eun Hee Chung, Kyunghoon Kim, Bong-Seong Kim, Cheol Hong Kim, Yang Park, Meeyong Shin, Kyung Suk Lee, Man Yong Han, Soo-Jong Hong, Eun Kyeong Kang, Chang Keun Kim; on behalf of The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease
Clin Exp Pediatr. 2023;66(3):134-141.   Published online December 22, 2022
Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown.
Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV.
Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic.
Review Article
Gastroenterology
Role of social media use in onset of functional gastrointestinal disorders in children
Mauro Cinquetti, Vanessa Dargenio, Michele Fingerle, Carolina Marchiotto, Marco Biasin, Massimo Pettoello Mantovani, Flavia Indrio
Clin Exp Pediatr. 2023;66(6):226-232.   Published online December 21, 2022
· Social media use can cause adverse health outcomes, including gastrointestinal disorders, in children and adolescents.
· Recent findings have shown a high prevalence of social media use and decreased well-being in patients with functional gastrointestinal disorders.
· The biopsychosocial nature of functional gastrointestinal disorders and the clear influence of social media on the psychosocial lives of children suggests the likely involvement of social media in their development.
Liver fibrosis in children: a comprehensive review of mechanisms, diagnosis, and therapy
Elif Ozdogan, Cigdem Arikan
Clin Exp Pediatr. 2023;66(3):110-124.   Published online December 19, 2022
· Chronic liver diseases in children are heterogenous but converge in the common pathway of fibrosis.
· Much of the literature on mechanisms of fibrogenesis focus on adults but pediatric physiology has documented differences.
· Understanding of these distinctions are necessary to define, treat, and prevent fibrosis.
· Current management of liver fibrosis relies heavily on liver biopsy. Multiple tools have shown high diagnostic performance in pediatric and adult populations. Large, multicenter studies are needed for validation.
Original Article
Neonatology (Perinatology)
A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants
Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun
Clin Exp Pediatr. 2023;66(1):32-37.   Published online December 15, 2022
Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.
Editorial
Neurology
Lumbar puncture or not: when does febrile seizure require a neurodiagnostic evaluation?
Seung Soo Kim
Clin Exp Pediatr. 2023;66(2):68-69.   Published online December 9, 2022
· A neurodiagnostic evaluation (lumbar puncture, blood tests, electroencephalography, and neuroimaging) is not indicated in most patients with simple febrile seizures.
· A lumbar puncture is indicated when a central nervous system infection is suspected in any patient with febrile seizures.
· Blood tests (glucose, electrolytes, and complete blood count) are indicated in patients with persistent seizure after benzodiazepine treatment, prolonged loss of consciousness, poor general condition, or signs of dehydration.
Pulmonology
Wheezing in infants and preschoolers: phenotypes and treatment options
Jung Yeon Shim
Clin Exp Pediatr. 2023;66(1):26-27.   Published online December 6, 2022
· Knowing who will develop into asthma or who will not is important to impose proper treatment and early intervention in a child with the first episode of wheezing.
· Phenotypes of severe bronchiolitis in less than 2-year-old children with first episode of wheezing were suggested for different treatment options
· RV-induced and/or atopy-associated severe wheezing in preschool children may benefit from early intervention of asthma treatment.
Letter to the Editor
Critical Care Medicine
Role of serum bilirubin-to-albumin ratio as a prognostic index in critically ill children
You Min Kang, Ga Eun Kim, Mireu Park, Jong Deok Kim, Min Jung Kim, Yoon Hee Kim, Kyung Won Kim, Myung Hyun Son, Soo Yeon Kim
Clin Exp Pediatr. 2023;66(2):85-87.   Published online December 5, 2022
Original Article
Neonatology (Perinatology)
Efficacy of body position on gastric residual in preterm infant: a systematic review and meta-analysis
Kurvatteppa Halemani, Alwin Issac, Sanjay Dhiraaj, Prabhaker Mishra
Clin Exp Pediatr. 2023;66(6):262-270.   Published online November 30, 2022
Breastfeeding and it's tolerance are the positive indicators for preterm babies. Placing the preterm infant in the right lateral or prone position after feed had lesser gastric residual volume compared to placing them in left lateral or supine positions. The post-feed position is a vital element in enhancing feeding tolerance, mechanical functions of the gastrointestinal tract and the overall development of preterm infants.
Gastroenterology
Association between maternal weight gain during pregnancy and child’s body mass index at preschool age
Jeewon Shin, Yoowon Kwon, Ju Hee Kim, Su Jin Jeong
Clin Exp Pediatr. 2023;66(2):76-81.   Published online November 30, 2022
Question: What are the risk factors of newborn birth weight? Does gestational weight gain and prepregnancy body mass index affect childhood weight?
Finding: Excess maternal weight gain increases the risk of overweight/obesity, newborn birth weight, and child body mass index at 4–6 years.
Meaning: Maternal weight control before and during pregnancy should be well controlled.
Neurology
Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review
Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga
Clin Exp Pediatr. 2023;66(1):38-45.   Published online November 30, 2022
· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.
Editorial
Neonatology (Perinatology)
Does cord blood cortisol have a mediating effect on maternal prepregnancy body mass index and birth weight?
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(1):24-25.   Published online November 30, 2022
· A high prepregnancy body mass index (pre-BMI) is associated with large for gestational age (LGA) and macrosomia, whereas a low pre-BMI is associated with small for gestational age (SGA) and low birth weight (LBW).
· The identification of the role of the hypothalamus-pituitary-adrenal axis in the effect of pre-BMI and maternal gestational weight gain on birth weight could reduce the frequency of LGA, macrosomia, SGA, or LBW through maternal diet optimization.
Allergy
Clinical considerations and practical issues of allergic diseases in COVID-19 era
Sungsu Jung
Clin Exp Pediatr. 2022;65(12):587-588.   Published online November 29, 2022
The risk of sudden acute respiratory syndrome coronavirus 2 infection and severe coronavirus disease 2019 (COVID-19) outcomes is not elevated in patients with the type 2 phenotype and well-controlled asthma. Inhaled corticosteroids, intranasal corticosteroids, and topical steroids can be safely used in COVID-19 patients. Biologics can be safely used by patients with allergic diseases without concern about antibody responses.
Review Article
Nutrition
Association of gut microbiota with obesity in children and adolescents
Ky Young Cho
Clin Exp Pediatr. 2023;66(4):148-154.   Published online November 16, 2022
The gut microbiota is an emerging factor in the development of pediatric obesity, which is affected by renowned risk factors such as diet, lifestyle, and socioeconomic status. This review aimed to describe the association between the gut microbiota and childhood obesity.
Editorial
Pulmonology
Community-acquired pneumonia in Korean children: time to read between the lines
Dong In Suh
Clin Exp Pediatr. 2023;66(1):22-23.   Published online November 10, 2022
· Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children
· Factors other than etiology are equally important to a compre hensive understanding of CAP
· Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification
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