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Editorial
Allergy
Comorbidities of allergic rhinitis in children
Yong Ju Lee
Clin Exp Pediatr. 2024;67(12):675-676.   Published online July 31, 2024
· Allergic rhinitis in children often goes undiagnosed or untreated, with significant systemic complications like sleep disorders, growth issues, and gastrointestinal symptoms linked to nasal obstruction.
· A patient-centered action plan that considers symptom severity, preferences, and comprehensive management of associated complications is essential for effective treatment.
Advancements in food allergen immunotherapy: improving quality of life and reducing risks
Jihyun Kim
Clin Exp Pediatr. 2024;67(12):672-674.   Published online July 31, 2024
· Pediatric food allergies considerably impair patient and family quality of life, particularly those with persistent allergies to common food allergens.
· Recent research has focused on developing diverse approaches to food allergen immunotherapy, showing promising outcomes of oral, sublingual, and epicutaneous immuno therapies.
· Critical considerations in immunotherapy candidate selection underscore the need for personalized approaches and reliable biomarkers in future studies to improve treatment outcomes.
Infection
Preventing bloodstream infections in children after liver transplantation
Young June Choe
Clin Exp Pediatr. 2024;67(11):599-600.   Published online April 18, 2024
Liver transplantation (LT) is crucial for children with end-stage liver diseases, yet bloodstream infections (BSI) pose significant risks, despite medical advancements. Immunosuppressants, essential for preventing organ rejection, heighten infection susceptibility. Understanding BSI organisms is vital due to antimicrobial resistance. Pediatric LT recipients have unique risk factors, demanding tailored preventive measures. This systematic review on bacterial BSI emphasizes the urgency of effective prevention strategies, considering the high incidence and distinct organism profile. Further research is vital for optimizing antibiotic management and improving outcomes for this vulnerable population.
Immunology
Utility of eosinophil granule proteins in management of pediatric chronic cough
Chang-Keun Kim
Clin Exp Pediatr. 2024;67(10):519-520.   Published online April 17, 2024
· Pediatric chronic cough often involves eosinophilic inflammation; however, objective measurements are not routinely used in treatment decisions.
· Accurate biomarkers of eosinophil activity, such as eosinophil-derived neurotoxin (EDN) and cationic proteins (ECP), should be used. EDN, which overcomes the shortcomings of ECP, recently received approval for use in Korean healthcare settings.
· EDN and ECP can play a role in treatment period and drug selection decisions.
Neurology
Impact of COVID-19 pandemic on clinical features of benign convulsions with mild gastroenteritis
Jon Soo Kim
Clin Exp Pediatr. 2024;67(9):456-458.   Published online March 25, 2024
· The frequency of benign convulsions with mild gastroenteritis (CwG) was not significantly influenced by the pandemic.
· The coronavirus disease 2019 pandemic has further diversified the etiologic enteric viral pathogens of CwG.
Critical Care Medicine
Is it possible to provide palliative care to pediatric patients with neurological diseases?
Young-Hoon Kim
Clin Exp Pediatr. 2024;67(8):403-404.   Published online February 15, 2024
· Patients with neurological diseases often require external mechanical support to maintain mechanical ventilation or supply.
· Little has been done to help the families of affected children make difficult decisions that carry significant physical and psychological consequences.
· The establishment of a department that provides pediatric palliative care for neurological patients should be considered.
Genetics and Metabolism
Advancing orphan drug development for rare diseases
Jung Min Ko
Clin Exp Pediatr. 2024;67(7):356-357.   Published online November 17, 2023
· Rare diseases present unique challenges and unmet needs for which the development of orphan drugs tailored to them offers hope.
· Despite the hurdles posed by limited patient populations, orphan drug designations from regulatory agencies provide incentives, such as extended market exclusivity and tax credits, that ignite transformative advances.
· Scientific progress in genomics, personalized medicine, and analytics empowers precise interventions by decoding genetic anomalies and encouraging effective treatments.
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.
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.
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.
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.
Endocrinology
Nonalcoholic fatty liver disease in children and adolescents
Hae Sang Lee
Clin Exp Pediatr. 2024;67(2):90-91.   Published online January 24, 2024
· With the increase in childhood obesity, nonalcoholic fatty liver disease (NAFLD) has become a concern in recent years.
· NAFLD is strongly associated with insulin resistance.
· Lifestyle modifications are the mainstay treatment for NAFLD.
Nephrology (Genitourinary)
Clinical considerations and practical issues of kidney complications in children after COVID-19 infection or vaccination
Jiwon Jung, Joo Hoon Lee
Clin Exp Pediatr. 2024;67(1):35-36.   Published online November 17, 2023
· The proper monitoring for and treatment of coronavirus disease 2019 (COVID-19)-induced acute kidney injury, which is common in critically ill children, are recommended.
· Glomerulopathy associated with COVID-19 or its vaccination has been reported, and the overall clinical course is similar to that of non-COVID-19-associated diseases.
· Additional COVID-19 vaccinations are recommended; however, careful and individualized decisions should be made in patients with COVID-19- or vaccination-associated glomerulopathy.
Infection
COVID-19 infection and vaccination among children
Amnuay Kleebayoon, Viroj Wiwanitkit
Clin Exp Pediatr. 2023;66(12):531-532.   Published online August 30, 2023
· Coronavirus disease 2019 (OVID-19) infection and immunization have been linked with kidney problems; however, causality has not been proven.
· Concern about confounders is usually needed.
· Correspondence about a published article on the COVID-19 vaccine
Gastroenterology
Noninvasive and simple, but accurate? Meta-analysis of evidence-based point-of-care ultrasound for assessing dehydration in children
Jin-Hee Oh
Clin Exp Pediatr. 2023;66(11):475-476.   Published online July 11, 2023
· Point-of-care ultrasound imaging, including measurement of the inferior vena cava/aorta ratio, is powerful for evaluating the hemodynamic status of pediatric patients.
· Owing to the limited feasibility of randomized clinical trials and insufficient data in children, imaging tools require validation.
· Objective validity meta-analyses of imaging studies can affect clinical decision-making and serve as a cornerstone for evidence-based practice in pediatrics.
Immunology
Systemic autoinflammatory disorders: autoinflammatory and autoimmune disorders
Young Dae Kim
Clin Exp Pediatr. 2023;66(10):439-440.   Published online July 4, 2023
· Systemic autoinflammatory disorders (SAIDs) typically have an early onset in life, and may have close relatives may have similar disease.
· SAIDs should be suspected in any patient, especially children, who experience persistent or recurrent inflammatory episodes that fail to fit the pattern of other established diseases.
· Advancements in the understanding of autoinflammation will provide novel diagnostic and therapeutic options for SAIDs patients.
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.
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.
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.
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.
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.
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.
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.
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.
Emergency Medicine
Current diagnosis and image-guided reduction for intussusception in children: teamwork approach
Ji-Hyun Seo
Clin Exp Pediatr. 2023;66(2):66-67.   Published online September 1, 2022
· The successful and safe enema reduction of intussusception depends primarily on the experience and preference of the radiologists and the availability of resources.
· The establishment of a standardized manual or protocol for reduction and pre-reduction treatment of intussusception, along with the collaboration of pediatricians, radiologists, and surgeons, is expected to improve the treatment success rate.
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.
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.
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
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.