Clinical and Experimental Pediatrics

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

Editorial

Neurobehavior

Importance of pediatrician’s role in preventing positional plagiocephaly

Hee-Jeong Kang

Clin Exp Pediatr. 2024;67(6):294-295. Published online May 21, 2024

· Plagiocephaly is characterized by the asymmetrical shape of a baby’s head.
· Since positional plagiocephaly is associated with developmental delay and further musculoskeletal problems, early detection allows for timely intervention and prevents worsening of the condition.
· Pediatricians can educate parents about proper head positioning and encourage supervised tummy time during awake hours.

DOI: https://doi.org/10.3345/cep.2023.01025

Review Article

Hematology

Iron deficiency in children with a focus on inflammatory conditions

Na Hee Lee

Clin Exp Pediatr. 2024;67(6):283-293. Published online May 21, 2024

Web of Science 2 Crossref 3

· Iron deficiency has important effects on neurodevelopment and the immune system in children.
· Hepcidine plays an important role in iron homeostasis.
· Diagnosis and treatment of iron deficiency in chronic inflammatory disease are important for patients' quality of life and disease course.

DOI: https://doi.org/10.3345/cep.2023.00521

Other

Use of virtual reality in children in a broad range of medical settings: a systematic narrative review of recent meta-analyses

Emily Antonovics, Grammatina Boitsios, Thomas Saliba

Clin Exp Pediatr. 2024;67(6):274-282. Published online May 21, 2024

Web of Science 3 Crossref 5

· Virtual reality (VR) is becoming increasingly common for entertainment and in medical settings.
· VR is useful for treating children with cerebral palsy.
· VR can help with attention deficit/hyperactivity disorder symptoms.
· VR can decrease pain perception in children undergoing burn wound care.
· VR can reduce preoperative anxiety.
· VR can reduce fear and pain during needle-involving procedures.

DOI: https://doi.org/10.3345/cep.2023.00388

Allergy

Action-plan and as-needed therapy in allergic rhinitis

Hyeon-Jong Yang

Clin Exp Pediatr. 2024;67(6):267-273. Published online May 21, 2024

Web of Science 3 Crossref 2

· The guidelines may not work in the real world.
· An action-plan reflecting patient’s severity and variable of symptoms, values and preferences as well as the benefits and harms of treatment, may be a useful alternative.
· The action plan and as-needed therapy must include the following elements: when, what, how, and why.
· Action plan and as-needed therapy can help patients manage their symptoms more effectively.

DOI: https://doi.org/10.3345/cep.2023.00654

Original Article

Pulmonology

Oligohydramnios affects pulmonary functional/structural abnormalities in school-aged children with bronchopulmonary dysplasia

Jeong Eun Shin, Soon Min Lee, Mi-Jung Lee, Jungho Han, Joohee Lim, Haerin Jang, Ho Seon Eun, Min Soo Park, Soo Yeon Kim, Myung Hyun Sohn, Ji Ye Jung, Kyung Won Kim

Clin Exp Pediatr. 2024;67(5):257-266. Published online April 16, 2024

Web of Science 3 Crossref 4

Question: Is bronchopulmonary dysplasia (BPD) associated with functional/structural abnormalities later in life?
Finding: School-aged children with severe BPD had abnormalities on pulmonary function tests and lung computed tomography despite no subjective respiratory symptoms; however, only prenatal oligohydramnios and prolonged ventilator use were associated with abnormal lung function.
Meaning: Long-term monitoring of preterm infants’ lung health is essential, especially for those with prenatal oligohydramnios or prolonged ventilator use.

DOI: https://doi.org/10.3345/cep.2023.01053

Neonatology (Perinatology)

Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial

Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi

Clin Exp Pediatr. 2024;67(5):249-256. Published online March 26, 2024

Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia?
Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants.
Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay.

DOI: https://doi.org/10.3345/cep.2023.01312

Editorial

Neonatology (Perinatology)

Exploring the role of laryngeal masks in neonatal resuscitation

Euiseok Jung

Clin Exp Pediatr. 2024;67(5):247-248. Published online December 28, 2023

· Laryngeal masks (LMs) offer stable airway access and skill retention advantages, making them promising alternatives to positive-pressure ventilation in neonatal care.
· The ease of teaching LM insertion techniques to less experienced providers addresses the need for swift intervention and skill retention.
· Careful consideration of the benefits and challenges of LMs is essential in determining their effective integration into enhanced neonatal resuscitation protocols.

DOI: https://doi.org/10.3345/cep.2023.01200

Review Article

Neonatology (Perinatology)

Updates in neonatal resuscitation: routine use of laryngeal masks as an alternative to face masks

Eun Song Song, Ga Won Jeon

Clin Exp Pediatr. 2024;67(5):240-246. Published online July 11, 2023

Web of Science 2 Crossref 2

In neonatal resuscitation:
· Laryngeal masks are recommended when endotracheal intubation or positive-pressure ventilation fails.
· Laryngeal masks are useful even during chest compressions.
· Laryngeal masks aid neonates >34 weeks’ gestation and/or with a birth weight >2 kg.
· Main usage barriers include limited experience (81%), preference for endotracheal tubes (57%), and lack of awareness (56%).
· Second-generation laryngeal masks have a built-in esophageal drainage tube that prevents regurgitation into the glottis, and an orogastric tube can be inserted within the esophageal drainage tube to protect against gastric inflation.

DOI: https://doi.org/10.3345/cep.2023.00619

Other

Children’s health affected by parent’s behavioral characteristics: a review

Sung Eun Kim, Jongin Lee

Clin Exp Pediatr. 2024;67(5):232-239. Published online August 21, 2023

Crossref 1

· Parents’ occupational hazards, long working hours, and smoking behaviors should be modified adequately to minimize adverse health effects on their children.
· As of 2023, several diseases from fetal exposure to occupational hazards can be compensated with Industrial Accident Compensation Insurance in South Korea.
· A directed acyclic graph is recommended for medical research to control the effects of parents’ behaviors on children’s health.

DOI: https://doi.org/10.3345/cep.2023.00115

Neonatology (Perinatology)

Influence of infant microbiome on health and development

Noelle Younge

Clin Exp Pediatr. 2024;67(5):224-231. Published online August 21, 2023

Web of Science 1 Crossref 2

· The infant gut microbiome is highly dynamic and individualized.
· Microbes are vertically transmitted from mother to infant during delivery and throughout infancy.
· Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function.
· In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems.
· Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality.

DOI: https://doi.org/10.3345/cep.2023.00598

Letter to the Editor

Neonatology (Perinatology)

Assessment of iron status and red cell parameters in healthy term small for gestational age neonates at birth

Arif Hossain, Shorna Rahman, Shahana Akter, Ismat Jahan, Sanjoy Kumer Dey, Abdul Mannan, Mohammod Shahidullah

Clin Exp Pediatr. 2024;67(4):221-223. Published online March 19, 2024

DOI: https://doi.org/10.3345/cep.2023.01445

Original Article

Neurology

Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study

Hyejin Na, Sanghoon Lee, Seo Hee Kim, Young Ok Kim

Clin Exp Pediatr. 2024;67(4):213-220. Published online March 19, 2024

Web of Science 2 Crossref 2

Question: Did coronavirus disease 2019 (COVID-19) affect the frequency, seasonal variation, or virus type of benign convulsions with mild gastroenteritis (CwG)?
Findings: We compared 41 cases of CwG before and during the COVID-19 pandemic. After March 2020, frequency did not change significantly (18 patients vs. 23 patients), seasonal variation was lost, and number of cases of enteric adenovirus-associated CwG increased (1 cases vs. 7 cases).
Meaning: The COVID-19 pandemic affected CwG.

DOI: https://doi.org/10.3345/cep.2023.01137

Nutrition

Effect of probiotics plus zinc supplementation on clinical outcomes of infants and children with acute infectious diarrhea: a randomized controlled trial

Deldar Morad Abdulah, Saad Jbraeil Sulaiman, Zaid Waad Ahmed

Clin Exp Pediatr. 2024;67(4):203-212. Published online February 19, 2024

Web of Science 3 Crossref 4

Question: Does zinc supplementation along with probiotics affect disease severity or clinical outcomes of children with acute diarrhea?
Findings: This study indicated that zinc supplementation and probiotics had no effect on clinical improvement or disease severity among pediatric patients with acute diarrhea.
Meaning: Children who received probiotics plus zinc recovered faster than those who received probiotics only.

DOI: https://doi.org/10.3345/cep.2023.01340

Editorial

Allergy

Trends in food allergen immunotherapy in Korea after changed national regulations

Tae Won Song

Clin Exp Pediatr. 2024;67(4):201-202. Published online November 21, 2023

National regulations, academic guidelines, and clinical trends in food allergen immunotherapies (FA-AIT) differ among countries and have changed rapidly. Current officially approved FA-AIT are oral immunotherapy (OIT) using heated milk/egg in Korea and peanut OIT using standardized products in the United States and Europe. FA-AIT should be administered by specialist physicians with experience administering oral food challenge tests and managing severe allergic reactions inside and outside research settings.

DOI: https://doi.org/10.3345/cep.2023.01123

Review Article

Nutrition

Macronutrients modified dietary intervention in the management of overweight/obese children and adolescents: a systematic review

Jihyun Park, Oh Yoen Kim

Clin Exp Pediatr. 2024;67(4):191-200. Published online July 11, 2023

· Dietary macronutrient modifications affect the body composition of and metabolic markers in children and adolescents.
· Hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children.
· Future interventional studies with meta-analyses that include Korean children and adolescents are needed to provide basic information applicable to this population.

DOI: https://doi.org/10.3345/cep.2023.00262

Cardiology

Heart failure in children and adolescents: an update on diagnostic approaches and management

Amit Agrawal, Dalwinder Janjua, Abdulrahman Ahmed Alsayed Ali Zeyada, Ahmed Taher Elsheikh

Clin Exp Pediatr. 2024;67(4):178-190. Published online June 19, 2023

Web of Science 2 Crossref 2

· Pediatric heart failure (PHF) is a clinical syndrome featuring various symptoms (shortness of breath, ankle swelling, fatigue) and signs (pulmonary crackles, peripheral edema).
· Congenital heart diseases are the most common underlying etiology of PHF, whereas myocarditis and primary cardio-myopathies are common in children without structural ab-normalities.
· PHF pathophysiology is complex and multifactorial and varies by etiology and age.
· PHF management includes decongestive therapy, treatment of underlying causes, preventing progression, and managing pulmonary or systemic obstructions.
· Drugs should be chosen based on pharmacodynamics, clinical manifestations, hemodynamic state, and renal function.

DOI: https://doi.org/10.3345/cep.2023.00528

Neonatology (Perinatology)

Neonatal family-centered care: evidence and practice models

Juyoung Lee

Clin Exp Pediatr. 2024;67(4):171-177. Published online June 14, 2023

Web of Science 4 Crossref 5

· Concrete evidence exists of early parent-infant attachment supported by family-centered care (FCC) in the neonatal intensive care unit.
· FCC involves the parents’ presence and participation in the infant’s care and decision-making.
· A private and comfortable space should be provided. A single-family room is ideal; however, a quiet space with a recliner can be a good alternative.
· Care culture changes and staff training are required.

DOI: https://doi.org/10.3345/cep.2023.00367

Letter to the Editor

Pulmonology

Metabolic syndrome and pulmonary dysfunction in asthmatic children during the COVID-19 pandemic

Jue Seong Lee, Sang Hyun Park, Yoon Lee, Seunghyun Kim, Wonsuck Yoon, Young Yoo

Clin Exp Pediatr. 2024;67(3):168-170. Published online February 19, 2024

Crossref 1

DOI: https://doi.org/10.3345/cep.2023.01480

Original Article

Cardiology

Effect of face mask on pulmonary artery pressure during echocardiography in children and adolescents

Alireza Ahmadi, Mohammad Reza Sabri, Zohreh Sadat Navabi

Clin Exp Pediatr. 2024;67(3):161-167. Published online January 23, 2024

Question: Can face masks alter pulmonary pressure in children and adolescents with and without congenital heart disease?
Findings: Mask removal during echocardiography (ECHO) reduced pulmonary pressure.
Meaning: These findings suggest that face masks should be removed during ECHO in children and adolescents.

DOI: https://doi.org/10.3345/cep.2023.01172

Neonatology (Perinatology)

Oral administration of bone marrow-derived mesenchymal stem cells attenuates intestinal injury in necrotizing enterocolitis

Yeong Seok Lee, Yong Hoon Jun, Juyoung Lee

Clin Exp Pediatr. 2024;67(3):152-160. Published online February 19, 2024

Web of Science 1 Crossref 1

Question: What is the optimal dose of bone marrow-derived mesenchymal stem cells (BM-MSCs) for treating necrotizing enterocolitis (NEC), and is orally administered BM-MSC effective?
Findings: High (1×10⁶ cells) or multiple BM-MSC doses showed similar effects as low (1×10⁵ cells) doses of intraperitoneally administered BM-MSCs. Furthermore, orally administered BM-MSCs were as effective as intraperitoneally administered BM-MSCs.
Meaning: Orally administered low-dose BM-MSCs are a potential treatment for NEC.

DOI: https://doi.org/10.3345/cep.2023.01151

Editorial

Neonatology (Perinatology)

Impacts of maternal COVID-19 during pregnancy on neonatal health and epidemiology

Jae Woo Lim

Clin Exp Pediatr. 2024;67(3):149-151. Published online December 28, 2023

Newborns born to mothers infected with coronavirus disease 2019 (COVID-19) should be closely monitored for respiratory disorders, such as transient tachypnea of the newborn, regardless of their COVID-19 test results. Further research is required of the development of infants born to mothers with COVID-19. The trends in Korea's birth rate and infant mortality rates have not been significantly affected by COVID-19.

DOI: https://doi.org/10.3345/cep.2023.01452

Review Article

Allergy

Practical issues of oral immunotherapy for egg or milk allergy

Sukyung Kim, Kangmo Ahn, Jihyun Kim

Clin Exp Pediatr. 2024;67(3):140-148. Published online June 19, 2023

Web of Science 2 Crossref 1

· Oral immunotherapy should be supervised by pediatricians with experience administering oral food challenge tests and managing allergic reactions.
· Food allergen intake is gradually increased and maintained for years.
· Patients may experience allergic reactions and psychological problems.
· Adjunctive therapies (biologics, antihistamines, and leukotriene receptor antagonists) may improve efficacy and safety.
· Contraindications include uncontrolled asthma, malignancy, active autoimmune disorders, and beta-blocker usage.

DOI: https://doi.org/10.3345/cep.2023.00234

Other

Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy

Lisa Zhao, John P. Jones, Lauren G. Anderson, Zacharoula Konsoula, Cynthia D. Nevison, Kathryn J. Reissner, William Parker

Clin Exp Pediatr. 2024;67(3):126-139. Published online June 14, 2023

Web of Science 4 Crossref 4

Despite worldwide acceptance of acetaminophen (paracetamol) in pediatric medicine, careful examination reveals no valid objections to the conclusion that early exposure to acetaminophen causes neurodevelopmental injury in susceptible babies and children. Nevertheless, debate that early exposure to acetaminophen causes neurodevelopmental injury has centered around the prenatal period, evidence of which is relatively limited compared to that in the postnatal period, which is the time of greatest absolute and relative risk.

DOI: https://doi.org/10.3345/cep.2022.01319

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

Letter to the Editor

General Pediatrics

Vitamin B₁₂ deficiency in anemic children before versus after age 2 years: a form of hidden hunger in India

Sahil Goel, Ruchika Bhatnagar, Anita Kumari, Brig Prem Lochan Prasad, Lahar Sahai

Clin Exp Pediatr. 2024;67(2):116-118. Published online January 24, 2024

DOI: https://doi.org/10.3345/cep.2023.01347

Original Article

Neonatology (Perinatology)

Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis

Asha P. Shetty, Kurvatteppa Halemani, Alwin Issac, Latha Thimmappa, Sanjay Dhiraaj, Radha K, Prabhaker Mishra, Vijai Datta Upadhyaya

Clin Exp Pediatr. 2024;67(2):104-115. Published online November 14, 2023

Web of Science 7 Crossref 16

Question: What emotions do parents experience when their newborns are admitted to the neonatal intensive care unit (NICU)?
Finding: Mothers experienced more anxiety (51%), depression (31%), and stress (41%) symptoms than fathers (26%, 12%, and 22%, respectively).
Meaning: Parents often experience anxiety, stress, and depression following NICU admission. Healthcare workers are responsible for providing regular parental counseling.

DOI: https://doi.org/10.3345/cep.2023.00486

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

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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