- Letter to the Editor
- Developmental and Behavioral Medicine
- The influence of parental eating behaviors, child-feeding practices, and infants’ temperaments upon infants’ eating behaviors
- Goh Woon Lim, Kyoung Min Shin
- Clin Exp Pediatr. 2022;65(9):466-468. Published online June 27, 2022
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- Original Article
- Other
- Plastic bottle feeding produces changes in biochemical parameters in human infants – A pilot study
- Mahendra K. Pant, Abul. H. Ahmad, Manisha Naithani, Jayanti Pant
- Clin Exp Pediatr. 2022;65(9):459-465. Published online May 19, 2022
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Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants?
Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding.
Meaning: Plastic bottles feeding alters bodily functions in infants.
- Oncology
- Treatment outcomes of high-dose chemotherapy plus stem cell rescue in high-risk neuroblastoma patients in Thailand
- Kunanya Suwannaying, Piti Techavichit, Patcharee Komvilaisak, Napat Laoaroon, Nattee Narkbunnam, Kleebsabai Sanpakit, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Lalita Sathitsamitphong, Chalongpon Santong, Panya Seksarn, Suradej Hongeng, Surapon Wiangnon
- Clin Exp Pediatr. 2022;65(9):453-458. Published online May 24, 2022
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Question: This study aimed to elucidate the outcomes of high-risk neuroblastoma (HR-NB) patients treated with high-dose chemotherapy and stem cell rescue without immunotherapy.
Finding: The 5-year overall survival and event-free survival rates were 45.1% and 40.4%, respectively.
Meaning: High-dose chemotherapy plus stem cell rescue followed by cis-retinoic acid for 12 months is well tolerated and could improve survival in patients with HR-NB in limited resource settings.
- Editorial
- Endocrinology
- Bisphenol A leaching from polycarbonate baby bottles into baby food causes potential health issues
- Ga Won Jeon
- Clin Exp Pediatr. 2022;65(9):450-452. Published online July 25, 2022
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Can bisphenol A (BPA) leach out from polycarbonate baby bottles into baby food? BPA and other toxic materials can leach out from baby bottles and increase the risk of various health problems, including endocrine disturbances. Although the use of BPA in baby bottles has been banned, many developing countries still use it, which can cause health issues. Thus, public awareness of this issue is required.
- Cardiology
- Characteristics of z score systems for diagnosing coronary abnormalities in Kawasaki disease
- Gyeong-Hee Yoo
- Clin Exp Pediatr. 2022;65(9):448-449. Published online March 14, 2022
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Because of the various body sizes of children with Kawasaki disease (KD), coronary artery diameter requires normalization to the body surface area as a z score.
In updated guidelines, coronary artery abnormalities are important criteria in the diagnosis of KD, and z score systems have been accepted to define coronary artery abnormalities.
However, the z score formula should be selected carefully because each yields different results.
- Review Article
- Gastroenterology
- Factors influencing development of the infant microbiota: from prenatal period to early infancy
- Sujin Jeong
- Clin Exp Pediatr. 2022;65(9):439-447. Published online December 23, 2021
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∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial.
∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage.
∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life.
∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism.
- Cardiology
- Diagnosis of coronary artery abnormalities in Kawasaki disease: recent guidelines and z score systems
- Sung Hye Kim
- Clin Exp Pediatr. 2022;65(9):430-438. Published online December 17, 2021
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∙ Kawasaki disease is the leading cause of acquired heart disease among children in the developed countries, and Korea has the second-highest incidence in the world.
∙ Early diagnosis and proper treatment are imperative to prevent coronary complication, and evaluation of coronary artery abnormalities is fundamental.
∙ Recent guidelines have adapted z score system for the diagnosis of coronary artery abnormalities in Kawasaki disease.
∙ Applying z score in diagnosis of coronary abnormalities has better correlation with clinical outcomes than absolute cutoff values.
∙ Calculated z scores could be different according to the z score formula, which might influence the treatment plan.
- Neonatology (Perinatology)
- Breastfeeding and vitamin D
- Ju Sun Heo, Young Min Ahn, Ai-Rhan Ellen Kim, Son Moon Shin; for the Korean Society of Breastfeeding Medicine
- Clin Exp Pediatr. 2022;65(9):418-429. Published online December 14, 2021
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∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes.
∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%.
∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants.
∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life.
∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring.
- Retraction Notice
- Coronavirus disease 2019 in a 2-month-old male infant: a case report from Iran
- Hosein Heydari, Seyed Kamal Eshagh Hossaini, Ahmad Hormati, Mahboubeh Afifian, Sajjad Ahmadpour
- Clin Exp Pediatr. 2022;65(8):417-417. Published online July 19, 2022
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- Original Article
- Cardiology
- Early myocardial functional abnormalities in primary dyslipidemia: clinical and echocardiographic observations in young children from a highly consanguineous population
- Nehal M. El-koofy, Aya M. Fattouh, Areef Ramadan, Mohamed A. Elmonem, Dina H. Hamed
- Clin Exp Pediatr. 2022;65(8):410-416. Published online December 8, 2021
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In children with primary dyslipidemia, functional myocardial abnormalities can occur at young age, including diastolic functional impairment of both ventricles and narrowing of the aortic valve and the sinus of Valsalva. Echocardiographic evaluations of high-risk children may be as important as biochemical evaluations.
- Hematology
- Effect of cyclic pamidronate administration on osteoporosis in children with β-thalassemia major: a single-center study
- Mahmoud A. El-Hawy, Nagwan Y. Saleh
- Clin Exp Pediatr. 2022;65(8):405-409. Published online June 7, 2022
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Question: What is the effect of cyclic pamidronate administration on osteoporosis in children with β-thalassemia major?
Finding: The dual-energy x-ray absorptiometry scan findings of children with β-thalassemia major and osteoporosis were improved after pamidronate administration.
Meaning: Cyclic pamidronate effectively treated osteoporosis in children with β-thalassemia major.
- Editorial
- Neonatology (Perinatology)
- Factors to consider before implementing telemedicine protocols to manage neonatal jaundice
- Heui Seung Jo
- Clin Exp Pediatr. 2022;65(8):403-404. Published online April 12, 2022
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In the rapidly changing environmental situation during the coronavirus disease 2019 outbreak, neonatal centers have developed telemedicine systems with extended coverage for neonatal monitoring and high-risk follow-up programs including neonatal hyperbilirubinemia. At this point, electronic health technology and noncontact medical system increase the effectiveness of rather than replacing the face-to-face visit and the opinions of experienced neonatologists.
- Pulmonology
- Now lung ultrasound has been established as a fundamental examination in pediatric respiratory diseases
- Kyunghoon Kim
- Clin Exp Pediatr. 2022;65(8):401-402. Published online July 13, 2022
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· Several studies demonstrated the usefulness of lung ultrasound in pediatric respiratory diseases including coronavirus disease 2019.
· Knowledge of lung ultrasound is increasing, and lung ultrasound has been established as a fundamental diagnostic examination for pediatric respiratory diseases.
- Cardiology
- Early echocardiographic screening for subclinical myocardial dysfunction in children and adolescents with dyslipidemia: why and when?
- Hyun Gyung Lee, Hwa Jin Cho
- Clin Exp Pediatr. 2022;65(8):398-400. Published online March 7, 2022
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Dyslipidemia contributes to early atherosclerosis, premature cardiovascular disease, and subclinical ventricular dysfunction in children. This paper highlights the need for echocardiographic evaluation for impaired diastolic function of both ventricles and narrowing of the aortic valve and sinus of Valsalva. Therefore, early echocardiographic screening of children with primary hyperlipidemia should be considered.
- Review Article
- Neurology
- Neonatal seizures: diagnostic updates based on new definition and classification
- Eun-Hee Kim, Jeongmin Shin, Byoung Kook Lee
- Clin Exp Pediatr. 2022;65(8):387-397. Published online April 4, 2022
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· Neonatal seizures are often electrographic-only seizures without clinical signs; therefore, the identification of electrical seizure activity on electroencephalography is the gold standard for diagnosis.
· Clinical signs of neonatal seizures are divided into motor or nonmotor seizures, and motor seizures are mostly focal or multifocal.
· Most neonatal seizures are caused by acute symptomatic etiologies, but in cases of intractable seizures, structural, genetic, or metabolic etiologies should be investigated.
- Infection
- Therapeutics for the treatment of coronavirus disease 2019 in children and adolescents
- Soo-Han Choi, Jae Hong Choi, Ki Wook Yun
- Clin Exp Pediatr. 2022;65(8):377-386. Published online June 27, 2022
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· Children and adolescents with high risks for severe coronavirus disease 2019 (COVID-19) should be identified and proper treatment should be provided promptly according to the patient’s condition.
· Remdesivir can be considered for pediatric patients of all ages with COVID-19 who have an emergent or increase in supplemental oxygen.
· The use of corticosteroids is not recommended for patients with nonsevere COVID-19. Corticosteroids are recommended in children and adolescents with severe and critical COVID-19.
- Nephrology (Genitourinary)
- Neonatal hypertension: concerns within and beyond the neonatal intensive care unit
- Kathleen Altemose, Janis M. Dionne
- Clin Exp Pediatr. 2022;65(8):367-376. Published online May 30, 2022
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Some neonates, especially those who are premature, may experience hypertension while in the neonatal intensive care unit (NICU). The most common causes are prematurity-related and the hypertension usually resolves over the first 1–2 years of life. Unfortunately, the increasing population of NICU graduates is at risk for later cardiovascular and kidney disease in childhood and adulthood. This population requires careful attention to blood pressure and weight throughout their life course.
- Original Article
- Infection
- Role of lung ultrasound patterns in monitoring coronavirus disease 2019 pneumonia and acute respiratory distress syndrome in children
- Satyabrata Roychowdhoury, Subhajit Bhakta, Manas Kumar Mahapatra, Saptarshi Ghosh, Sayantika Saha, Mithun Chandra Konar, Mihir Sarkar, Mousumi Nandi
- Clin Exp Pediatr. 2022;65(7):358-366. Published online May 13, 2022
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Question: Potential role of patterns of lung ultrasonography (US) in monitoring changes in mechanically ventilated patients with coronavirus disease 2019 (COVID-19) pneumonia.
Finding: Interstitial syndrome, an irregular pleural line, and peripheral microconsolidation were the most prevalent findings. Changes in lung aeration after mechanical ventilation corelated with improved oxygenation. A fall in lung ultrasound reaeration score ≤ 5 may predict successful weaning.
Meaning: Lung US is gaining wider utility for monitoring COVID-19 pneumonia.
- Neonatology (Perinatology)
- Neonatal sepsis-causing bacterial pathogens and outcome of trends of their antimicrobial susceptibility a 20-year period at a neonatal intensive care unit
- Woo Sun Song, Hye Won Park, Moon Youn Oh, Jae Young Jo, Chae Young Kim, Jung Ju Lee, Euiseok Jung, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
- Clin Exp Pediatr. 2022;65(7):350-357. Published online December 9, 2021
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Question: What is prevalence of bacterial pathogens causing sepsis and their antimicrobial susceptibility over 20 years?
Finding: Coagulase-negative remains most common causative organism. The most common gram-negative organism was Klebsiella pneumonia. The susceptibility of staphylococcus aureus and K. pneumonia showed increased susceptability to oxacillin, cefotaxime and amikacin, gentamicin, respectively.
Meaning: Answers to the question asked is important in choosing antimicrobials and to monitor emergence of multidrug-resistant organisms.
- Editorial
- Pulmonology
- Influence of coronavirus disease 2019 pandemic on respiratory health in children
- Hyo-Bin Kim
- Clin Exp Pediatr. 2022;65(7):348-349. Published online May 3, 2022
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· Practicing hand hygiene, wearing a mask, maintaining social distancing, and other lockdown measures were implemented to reduce the spread of coronavirus disease 2019 (COVID-19), a worldwide disaster that started in 2019.
· The advent of the worldwide COVID-19 pandemic resulted in positive secondary effects, such as reduced respiratory viral infections in children and decreased degrees of air pollution.
- Neonatology (Perinatology)
- Ideal timing for aggressive screening to detect developmental dysplasia of the hip in term and preterm infants
- Won-Ho Hahn
- Clin Exp Pediatr. 2022;65(7):346-347. Published online March 14, 2022
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The risk factors and pathogenesis of developmental dysplasia of the hip (DDH) are unclear. Moreover, no universal screening method can entirely eliminate the risk of DDH. However, its incidence is significant and its early detection is critical for improving patient prognosis. Although the ideal evaluation time and risk factors, especially for premature infants, are unclear, the necessity for DDH screening programs for term and preterm infants is emerging.
- Nutrition
- Human milk oligosaccharides as immunonutrition key in early life
- Jung Ok Shim
- Clin Exp Pediatr. 2022;65(7):344-345. Published online May 3, 2022
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· Human milk is a major source of immunonutrients for neonates and infants. Human milk oligosaccharides (HMOs) act as prebiotics and promote the growth of commensal bacteria.
· HMOs inhibit microorganism adhesion to the gut mucosa through interactions with the commensal microbiome and improve gut barrier function by increasing short-chain fatty acid mediated by bifidobacteria and immunomodulation.
· Several randomized controlled trials recently reported on HMOs.
- Review Article
- Gastroenterology
- Clinical importance of immunonutrition in infants: a review of the recent literature
- Ji Sook Park
- Clin Exp Pediatr. 2022;65(7):337-343. Published online February 17, 2022
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Nutrients are important in the developing immune system. Human milk supplies diverse bioactives to prevent acute infection or chronic inflammation. Immunoglobulins, lactoferrin, and glutamine in human milk decrease gastrointestinal and respiratory infection. Human milk oligosaccharides promote the growth of intestinal microbiota, the gut barrier, and antimicrobial or antiviral activity. Micronutrients act as anti-inflammatory immunonutrients, too. However, the toxicity of some nutrients from an overdose should be considered.
- Other
- Epidemiology of pediatric fractures before versus during the coronavirus disease 2019 pandemic
- Chi Hoon Oh, Siyeong Yoon, Kyung Rae Ko, Young Woo Kwon, Kyeong Mi Kim, Hyun Seo Park, Hogyeong Kang, Inseok Jang, Soonchul Lee
- Clin Exp Pediatr. 2022;65(7):330-336. Published online June 3, 2022
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∙ The novel coronavirus disease 2019 (COVID-19) was first reported in December 2019 as a cluster outbreak in Wuhan, since then, national lockdowns have included school closures, stay-at-home orders.
∙ The characteristics of adolescent fractures were often related to physical activity such as sports-related injury.
∙ During the COVID-19 pandemic, both in the East and the West, the incidence of fractures in children and adolescents is showing a decreasing trend worldwide.
∙ Fractures in children and adolescents were significantly reduced in the proportion of relatively low-energy damage, and the incidence of fractures in adolescents with greater activity compared to children was reduced.
∙ If COVID-19 pandemic ends, normal academic and sports activities increase due to the easing of lockdown policies, the number of trauma patients related to increased activity may increase rapidly, and clinics should prepare for this change.
- Neurobehavior
- Jeopardized mental health of children and adolescents in coronavirus disease 2019 pandemic
- Bohyun Jin, Sohee Lee, Un Sun Chung
- Clin Exp Pediatr. 2022;65(7):322-329. Published online June 3, 2022
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∙ The coronavirus disease 2019 (COVID-19) pandemic has required preventive measures like self-quarantine, school closures, and lockdown, which ultimately make youth directly and indirectly vulnerable to depression, anxiety, posttraumatic stress disorder, and somatization.
∙ Child abuse is more common in the COVID-19 era than previously.
∙ Pediatricians should carefully examine parental and child mental health to directly and indirectly aid their physical and mental health.
- Letter to the Editor
- Infection
- Changes in epidemiology of parainfluenza virus and respiratory syncytial virus infection during coronavirus disease 2019 pandemic in Korea
- Kyung-Ran Kim, Hwanhee Park, Doo Ri Kim, Yae-Jean Kim
- Clin Exp Pediatr. 2022;65(6):320-321. Published online March 10, 2022
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Question: How the epidemiology of other childhood respiratory viruses has changed during coronavirus disease 2019 (COVID-19) in Korea?
Finding: Parainfluenza virus (PIV) typically circulated in the spring, and respiratory syncytial virus (RSV) epidemic started in autumn in Korea before COVID-19 pandemic. PIV and RSV seasons disappeared in 2020 and came back in 2021 with atypical seasonality. PIV season was changed from spring to autumn, and the beginning of RSV season was slightly delayed from autumn to early winter in 2021.
Meaning: Circulation of PIV and RSV was changed to unusual seasons and patterns during COVID-19 pandemic period.
- Original Article
- Neurology
- Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the National Health Screening Program for Infants and Children database
- Og Hyang Kim, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, Yun Hye Jo, Seongyeong Rhie, Man Yong Han, Kyu Young Chae
- Clin Exp Pediatr. 2022;65(6):312-319. Published online December 9, 2021
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Question: What comorbidities are increased in children with congenital muscular torticollis (CMT)? Are there differences in the neurodevelopmental outcomes of children with CMT who received physical therapy versus those who did not?
Finding: The risk of congenital musculoskeletal deformities is increased in CMT. Children who did not receive physical therapy were at greater risk of neurodevelopmental delay.
Meaning: In CMT, musculoskeletal comorbidities should be identified and active early treatment provided.
- Endocrinology
- Effects of probiotics combined with dietary and lifestyle modification on clinical, biochemical, and radiological parameters in obese children with nonalcoholic fatty liver disease/nonalcoholic steatohepatitis: a randomized clinical trial
- Thushara Rodrigo, Samaranayake Dulani, Sumudu Nimali Seneviratne, Arjuna P. De Silva, Jerad Fernando, H. Janaka De Silva, Jayasekera , V. Pujitha Wickramasinghe
- Clin Exp Pediatr. 2022;65(6):304-311. Published online November 11, 2021
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Question: Could probiotics be used as a therapeutic modality in nonalcoholic fatty liver disease/nonalcoholic steatohepatitis?
Finding: There seem no added advantages over lifestyle modifications compared to Probiotics.
Meaning: There does not seem to be an advantage of probiotics over lifestyle modifications in improving obesity-associated metabolic derangement in children.
- Editorial
- Cardiology
- Coronavirus disease 2019 and mRNA vaccines: what’s next – miRNA?
- Joon Kee Lee, Heon-Seok Han
- Clin Exp Pediatr. 2022;65(6):302-303. Published online March 28, 2022
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MicroRNAs (miRNAs) are small single-stranded noncoding RNA molecules that function in RNA silencing and the posttranscriptional regulation of gene expression. The potential role of miRNAs as biomarkers of myocarditis is promising, and miRNAs are expected to be utilized in various clinical fields in the future.
- Endocrinology
- Low bone mineral density can occur in children after shortterm systemic glucocorticoid treatment
- Moon Bae Ahn
- Clin Exp Pediatr. 2022;65(6):300-301. Published online April 27, 2022
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Osteoporosis diagnosed in children with chronic diseases is a major endocrine complication triggered by the disease itself or its treatment. Although age upon starting osteotoxic agents and the their duration of use are vital contributors, spontaneous recovery of bone mass following treatment completion is a privilege of this specific age group. For any patients short-term glucocorticoid therapy, bone health screening is the next step.
