Clinical and Experimental Pediatrics

Review Articles

Other

Cost-effectiveness of newborn screening for severe combined immunodeficiency: a systematic review

Rezwanul Rana, Syed Afroz Keramat, Moin Ahmed

Clin Exp Pediatr. 2025;68(9):628-640. Published online April 16, 2025

Universal newborn screening for severe combined immunodeficiency (SCID) demonstrates robust cost-effectiveness across diverse high-income healthcare systems, both from healthcare and societal standpoints. Early detection yields substantial savings. While uncertainties persist, impacting precise cost-effectiveness, the overall finding is positive. Future research must prioritize enhanced data collection and statistical rigor to refine our understanding of SCID's economic impact within the Australian context.

DOI: https://doi.org/10.3345/cep.2025.00052

Artificial intelligence in pediatric healthcare: current applications, potential, and implementation considerations

Taejin Park, In-Hee Lee, Seung Wook Lee, Sek Won Kong

Clin Exp Pediatr. 2025;68(9):641-651. Published online June 25, 2025

Crossref 1

Artificial intelligence (AI) offers potential benefits in pediatric care, but its real-world adoption requires clinician literacy, ethical and legal safeguards, and cautious implementation. Large language models are emerging across healthcare, but their use in pediatric clinical practice remains premature. Thus, the cautious and accountable implementation of AI is crucial to preventing unintended harm and realizing its potential.

DOI: https://doi.org/10.3345/cep.2025.00962

Editorial

General Pediatrics

Artificial intelligence in pediatric healthcare: bridging potential, clinical practice, and ethical considerations

Yoon Lee, Seohyun Hong, Dong Keon Yon

Clin Exp Pediatr. 2025;68(9):652-655. Published online August 28, 2025

· Artificial intelligence (AI) holds transformative potential for pediatric healthcare, with applications spanning prevention, diagnosis, treatment, and follow-up across diverse subspecialties; however, ethical concerns, scarcity of pediatric- specific data, and limited funding remain significant challenges.
· International consensus on pediatric AI guidelines, expanding child-specific datasets, and incorporating explainable AI are essential to ensure safety and trust.
· Multicenter collaboration and increased investment can address these gaps, enabling equitable, reliable, and pediatric- centered AI solutions.

DOI: https://doi.org/10.3345/cep.2025.01844

Original Articles

Neonatology (Perinatology)

Respiratory severity score-guided postnatal systemic corticosteroid therapy for bronchopulmonary dysplasia in extremely preterm infants

Gyeong Eun Yeom, Ju Sun Heo, Baek Sup Shin, Seh Hyun Kim, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim

Clin Exp Pediatr. 2025;68(9):656-665. Published online July 8, 2025

Question: Does a respiratory severity score (RSS)-guided postnatal corticosteroid protocol improve respiratory outcomes of extremely preterm (EP) infants without worsening neurodevelopmental outcomes?
Finding: The protocol enabled targeted and early steroid use, thereby reducing severe bronchopulmonary dysplasia without affecting mortality or causing neurodevelopmental impairments.
Meaning: The RSS-guided protocol may offer a more precise and individualized postnatal corticosteroid therapy for EP infants.

DOI: https://doi.org/10.3345/cep.2025.00514

Nutrition

Factors associated with thiamin deficiency in pediatric patients with heart disease and receiving diuretics: a single-center study

Phakwan Laohathai, Rathaporn Sumboonnanonda, Puthita Saengpanit, Chodchanok Vijarnsorn, Chatchawan Srisawat, Kwanjai Chotipanang, Sarawut Junnu, Supawan Kunnangja, Hathaichanok Rukprayoon, Phakkanan Phuangphan, Sompong Liammongkolkul, Arthima Phaokong, Narumon Densupsoontorn

Clin Exp Pediatr. 2025;68(9):666-672. Published online April 16, 2025

Question: Are pediatric patients with heart disease who are receiving diuretics at risk of thiamin deficiency (TD)?
Finding: Fifteen percent of the patients had TD. TD was associated with inadequate dietary thiamin intake and increasing age.
Meaning: The thiamin pyrophosphate effect should be assessed in those with high risk of TD. Dietary counseling should be emphasized to ensure adequate dietary thiamin intake.

DOI: https://doi.org/10.3345/cep.2024.01893

Cardiology

Vasovagal syncope and postural orthostatic tachycardia syndrome in adolescents: transcranial doppler versus autonomic function test results

Dong Won Lee

Clin Exp Pediatr. 2025;68(9):673-679. Published online August 6, 2025

Question: Vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) are representative forms of neurally mediated syncope. What influences the occurrence of each?
Finding: Autonomic function test results did not differ, but cerebral blood flow during diastole on transcranial doppler differed between VVS and POTS.
Meaning: Differences in diastolic cerebral blood flow velocity play an important role in VVS and POTS.

DOI: https://doi.org/10.3345/cep.2025.00927

Pulmonology

Association of macrophage migration-inhibitory factor gene and growth differentiation factor 15 gene polymorphisms and their circulating levels with respiratory distress syndrome among preterm neonates

Ali Helmi Bakri, Mohammed H. Hassan, Khaled Abdalla Abd-Elbaseer, Mahmoud Abo-Alhassan Sayed, Ahmed Alamir Mahmoud Abdallah, Eman Ahmed Abd-Elmawgood

Clin Exp Pediatr. 2025;68(9):680-689. Published online April 1, 2025

Question: Do macrophage migration-inhibitory factor (MIF) and growth differentiation factor-15 (GDF-15) levels and their gene polymorphisms affect RDS among preterm babies?
Finding: Significantly higher serum MIF and GDF-15 levels were observed in patients with severe respiratory distress syndrome (RDS). The mutant G- and C-alleles of GDF-15 rs4808793 C>G single nucleotide polymorphism (SNP) and MIF rs755622 G>C SNP were present at significantly higher frequencies in preterm neonates with RDS.
Meaning: MIF and GDF-15 play a significant role in neonatal RDS and its severity.

DOI: https://doi.org/10.3345/cep.2025.00416

Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: a randomized controlled trial

Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh

Clin Exp Pediatr. 2025;68(9):690-699. Published online April 1, 2025

This study assessed the effects of vitamin C on children with community-acquired pneumonia (CAP). Vitamin C supplementation improved clinical symptoms within 48–72 hours compared to placebo but did not reduce the length of hospital stay (LOS). These findings suggest that vitamin C is beneficial for managing CAP severity, but does not affect LOS.

DOI: https://doi.org/10.3345/cep.2025.01970

Basic Research

Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement

Moein Ghasemi, Abolfazl Basiri, Houman Kazemzadeh, Mohammad Amin Manavi, Seyed Mohammad Tavangar, Ahmad Reza Dehpour, Hamed Shafaroodi

Clin Exp Pediatr. 2025;68(9):700-711. Published online August 26, 2025

Question: What pharmacological strategies can limit ischemia-reperfusion injury in pediatric patients with testicular torsion?
Finding: In a rat model of testicular torsion, linezolid reduced oxidative stress, inflammation, and tissue injury via the Toll-like receptor 4/mitogen-activated protein kinase/nuclear factor kappa beta pathway.
Meaning: Linezolid may offer a pharmacological approach to attenuate testicular damage in pediatric patients with testicular torsion, warranting further clinical investigation.

DOI: https://doi.org/10.3345/cep.2025.00080

Oncology

Allogeneic stem-cell transplantation following chimeric antigen receptor T-cell therapy for treatment of relapsed/refractory hematologic malignancy in children and young adults: a systematic review and meta-analysis

Ghea Mangkuliguna, Edi Setiawan Tehuteru, Reganedgary Jonlean, Nicholas Adrianto, Stella Kallista

Clin Exp Pediatr. 2025;68(9):712-721. Published online July 4, 2025

Question: Does consolidative allogeneic stem cell transplantation (allo-SCT) after chimeric antigen receptor (CAR) T-cell therapy improve outcomes of children and young adult patients with relapsed/refractory hematologic malignancies?
Finding: The meta-analysis showed reduced relapse rates and favorable survival trends with allo-SCT despite low evidence quality.
Meaning: Consolidative allo-SCT after CAR T-cell therapy may enhance survival; however, further clinical studies are needed.

DOI: https://doi.org/10.3345/cep.2025.00031

Gastroenterology

Treatment targeting pediatric inflammatory bowel disease-associated anemia: experience from a single tertiary center

Ana S.C. Fernandes, Sara Azevedo, Ana Rita Martins, Ana Isabel Lopes

Clin Exp Pediatr. 2025;68(9):722-731. Published online June 10, 2025

Question: Does treating iron deficiency (ID) using intravenous iron in pediatric inflammatory bowel disease (IBD) feature long-term safety and efficacy?
Finding: Intravenous iron supplementation was safe and effective. However, the ID recurrence rate was higher than expected.
Meaning: Proactive screening and treatment of ID in pediatric IBD are essential. The Ganzoni formula likely underestimates the iron requirements of pediatric patients. Prospective trials are needed to optimize iron treatment dosing.

DOI: https://doi.org/10.3345/cep.2025.00640

Cardiology

Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea

Soo In Jeong, GI Beom Kim, Sung Hye Kim, Jae Yoon Na, Hong Ju Shin, Sin Weon Yun, Lucy Youngmin Eun, Sang Yun Lee, Chang-Ha Lee, Kwang Ho Choi, Seul Gi Cha, Mi Young Han

Clin Exp Pediatr. 2025;68(9):732-741. Published online August 6, 2025

Question: What are the key challenges affecting pediatric cardiologists and cardiac surgeons in Korea?
Finding: Excessive workloads, low procedural volumes, and legal risks contribute to high burnout. Regional disparities limit skill maintenance and threaten workforce sustainability.
Meaning: Targeted policies ensuring fair workloads, legal protections, and regional support are essential to stabilizing the pediatric cardiac workforce and maintaining high-quality care.

DOI: https://doi.org/10.3345/cep.2025.01123

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