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Review Article
Infection
The COVID-19 pandemic: an unprecedented tragedy in the battle against childhood obesity
Maximilian Andreas Storz
Clin Exp Pediatr. 2020;63(12):477-482.   Published online November 5, 2020
Large-scale quarantine and home confinement during the coronavirus disease 2019 (COVID-19) pandemic will impose new and unfamiliar stressors on children, thereby worsening the childhood obesity epidemic. Physical, nutritional, and psychosocial factors that promote obesity in children during this special situation complementarily contribute to an unprecedented obesogenic environment. Involved stakeholders, including governments, schools, and families, must make all efforts to minimize the impact of the COVID-19 epidemic on childhood obesity.
Pulmonology
Current perspectives on atypical pneumonia in children
Jung Yeon Shim
Clin Exp Pediatr. 2020;63(12):469-476.   Published online June 10, 2020
Macrolides are the first line treatment in atypical pneumonia caused by M. pneumoniae, C. pneumoniae, and L. pneumophila. Macrolide-resistant mycoplasma pneumonia (MRMP) is emerging worldwide, especially in East Asia. Immune modulators such as corticosteroids or second line antibiotics are treatment options for MRMP. Pediatricians should be careful with empirical therapy of macrolides in children with mild to moderate community-acquired pneumonia not to increase the risk of MRMP.
Allergy
Pollen-food allergy syndrome in children
You Hoon Jeon
Clin Exp Pediatr. 2020;63(12):463-468.   Published online May 14, 2020
The prevalence of pollen-food allergy syndrome (PFAS) in Korean children with pollen allergy was recently reported to be 42.7%. PFAS can cause a wide range of symptoms from mild allergy to severe anaphylaxis depending on the nature of food allergens that share the epitopes with pollen. Cases of anaphylaxis caused by PFAS have recently increased. Treatments for PFAS should be individualized for patients according to the severity of symptoms.
Guideline
Endocrinology
2017 Clinical practice guidelines for dyslipidemia of Korean children and adolescents
Jung Sub Lim, Eun Young Kim, Jae Hyun Kim, Jae-Ho Yoo, Kyung Hee Yi, Hyun Wook Chae, Jin-Ho Choi, Ji Young Kim, Il Tae Hwang; the Committee of Dyslipidemia of Korean Children and Adolescents on behalf of Korean Society of Pediatric Endocrinology (KSPE)
Clin Exp Pediatr. 2020;63(12):454-462.   Published online November 25, 2020
Question: How are children and adolescents with dyslipidemia treated and managed in Korea?
Finding: 2017 guidelines recommend to measure nonfasting non-HDL-C as a screening test and introduce new diet methods: Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, CHILD-2-low-density lipoprotein cholesterol, and CHILD-2-triglyceride. Statin is the only drug approved in children older than 10 years.
Meaning: New clinical practice guidelines for treating and managing dyslipidemia of Korean children and adolescents are provided.
Clinical Note
Allergy
Recurrent urticaria caused by specific cat serum albumin IgE cross-reacting with pork serum albumin
Cheon Kim, Sung Won Kim, Yoon Ha Hwang
Clin Exp Pediatr. 2020;63(11):451-453.   Published online April 6, 2020
Question: What should be considered in children who complain of pork allergies?
Finding: History of raising a cat, the onset of symptoms after the ingestion of pork and specific IgE tests to pork, cat, milk, and Alpha-gal are needed.
Meaning: Pork cat syndrome could be the cause of pork allergies.
Original Article
Gastroenterology
Acquired noncaustic esophageal strictures in children
Elif Sag, Aysenur Bahadir, Mustafa Imamoglu, Sefa Sag, Gokce Pinar Reis, Erol Erduran, Murat Cakir
Clin Exp Pediatr. 2020;63(11):447-450.   Published online October 15, 2020
Question: Which clinical findings suggest esophageal structure in children with dysphagia?
Finding: The presence of solid dysphagia, malnutrition, and a comorbid condition is suggestive of esophageal stricture in children with dysphagia.
Meaning: Patients with findings suggestive of noncaustic esophageal stricture should receive early referral to pediatric gastroenterology units.
Developmental and Behavioral Medicine
Development of the Korean Developmental Screening Test for Infants and Children (K-DST)
Hee Jung Chung, Donghwa Yang, Gun-Ha Kim, Sung Koo Kim, Seoung Woo Kim, Young Key Kim, Young Ah Kim, Joon Sik Kim, Jin Kyung Kim, Cheongtag Kim, In-Kyung Sung, Son Moon Shin, Kyung Ja Oh, Hee-Jeong Yoo, Hee Joon Yu, Seoung-Joon Lim, Jeehun Lee, Hae-Ik Jeong, Jieun Choi, Jeong-Yi Kwon, Baik-Lin Eun
Clin Exp Pediatr. 2020;63(11):438-446.   Published online May 14, 2020
Question: Can the Korean Developmental Screening Test for Infants and Children (K-DST) be a useful screening tool for infants and children in Korea?
Finding: The K-DST has high reliability (internal consistency of 0.73–0.93, test-retest reliability of 0.77–0.88) and a high discriminatory ability with a sensitivity of 0.833 and specificity of 0.979.
Meaning: The K-DST is an effective and reliable screening tool for infants and children with neurodevelopmental disorders in Korea.
Neonatology (Perinatology)
Knowledge and perceptions of kangaroo mother care among health providers: a qualitative study
Hadi Pratomo, Tiara Amelia, Fatmawati Nurlin, Asri C. Adisasmita
Clin Exp Pediatr. 2020;63(11):433-437.   Published online July 21, 2020
Question: What are health providers’ knowledge and perceptions of Kangaroo mother care (KMC)?
Finding: Health providers’ knowledge of KMC was sufficient; however, some of their perceptions about it could create barriers to the successful implementation of hospital KMC programs.
Meaning: Health providers’ perceptions about KMC should be considered to ensure successful KMC implementation. Locally designed on-site training programs could overcome the challenges.
Editorial
Neonatology (Perinatology)
Barriers to and enablers of kangaroo mother care
Soon Min Lee
Clin Exp Pediatr. 2020;63(11):431-432.   Published online October 10, 2019
Nephrology (Genitourinary)
Undescended testis: importance of a timely referral to a surgical specialist
Su Jin Kim
Clin Exp Pediatr. 2020;63(11):429-430.   Published online March 23, 2020
Undescended testes (UDT) is the most common congenital genitourinary abnormality in male infants and associated with decreased fertility and a higher future malignancy risk, especially in cases of delayed orchiopexy after puberty. It is important to timely referral to a surgical specialist and timely surgical correction of UDT to improve fertility and decrease the risk of malignancy.
Review Article
Neurology
Health effects of electromagnetic fields on children
Jin-Hwa Moon
Clin Exp Pediatr. 2020;63(11):422-428.   Published online May 26, 2020
· The nervous systems of children are more vulnerable to the effects of electromagnetic waves than adults.
· The exposure to electromagnetic fields (EMFs) among children should be minimized.
· According to International Agency for Research on Cancer EMFs are possibly carcinogenic, it should not be overlooked or interpreted with bias.
Other
Comparison of diagnostic and treatment guidelines for undescended testis
Jaeho Shin, Ga Won Jeon
Clin Exp Pediatr. 2020;63(11):415-421.   Published online March 23, 2020
Primary caregivers should consider surgical specialist referral of patients with undescended testis if no descent occurs by 6 months, undescended testis is newly diagnosed after 6 months of age, or testicular torsion is suspected. Orchiopexy is recommended between 6 and 18 months at the latest. The original location of the testes and the age at orchiopexy are predictive factors for infertility and malignancy later in life.
Clinical Note
Nephrology (Genitourinary)
First episode of nephrotic syndrome with acute abdominal pain
Samridhi Goyal, Rachita Singh Dhull, Bobbity Deepthi, Abhijeet Saha
Clin Exp Pediatr. 2020;63(10):411-414.   Published online July 21, 2020
Question: What are the likely causes of pain abdomen in Nephrotic syndrome?
Finding: Severe hypovolemia leading to mesenteric ischemia, spontaneous bacterial peritonitis, gastroenteritis, adverse effect of corticosteroids leading to gastritis, mesenteric ischemia due to thromboembolism, acute appendicitis, intussusception due to severe gut wall oedema and rarely Psoas abscess.
Meaning: Clinical suspicion and careful investigation is warranted to diagnose rare cause of pain abdomen like Psoas abscess.
Original Article
Neonatology (Perinatology)
Risk-based maternal group B Streptococcus screening strategy is compatible with the implementation of neonatal early-onset sepsis calculator
Niek B. Achten, J. Wendelien Dorigo-Zetsma, Annemarie M.C. van Rossum, Rianne Oostenbrink, Frans B. Plötz
Clin Exp Pediatr. 2020;63(10):406-410.   Published online April 16, 2020
Question: To what extent does risk-based Group B Streptococcus (GBS) screening influence management recommendations by the early-onset sepsis (EOS) calculator?
Finding: In 97% of the newborn infants, the EOS calculator recommendation remained unchanged after the GBS status at birth was updated to the definitive GBS status.
Meaning: Risk-based GBS screening results are compatible with EOS calculator recommendations.
Endocrinology
Zinc transporter 8 autoantibody in the diagnosis of type 1 diabetes in children
Nur Rochmah, Muhammad Faizi, Siti Wahyu Windarti
Clin Exp Pediatr. 2020;63(10):402-405.   Published online October 6, 2020
Question: Can zinc transporter 8 autoantibody (ZnT8A) be used for diagnosing type 1 diabetes (T1D)?
Finding: Twenty-two of 30 subjects with type 1 diabetes (73.3 %) were positive for ZnT8A compared to 5 of 18 controls (27.8%).
Meaning: ZnT8A has potential for clinical applications in the diagnosis of T1D.
Neonatology (Perinatology)
New modified version of the Risk Adjustment for Congenital Heart Surgery category and mortality in premature infants with critical congenital heart disease
Young Mi Yoon, Seong Phil Bae, Yoon-Joo Kim, Jae Gun Kwak, Woong-Han Kim, Mi Kyoung Song, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
Clin Exp Pediatr. 2020;63(10):395-401.   Published online July 15, 2020
Questions: This study aimed to describe the survival of premature infants with critical congenital heart disease (CHD) and to identify the risk factors including the new modified version of the Risk Adjustment for Congenital Heart Surgery (M-RACHS) associated with mortality.
Finding: For premature infants with critical CHD, survival rate was 76.9% and very low birth weight (VLBW), persistent pulmonary hypertension of the newborn (PPHN), bronchopulmonary dysplasia (BPD), and M-RACHS 5 or more were associated with in-hospital mortality.
Meaning: VLBW, PPHN and BPD, as well as M-RACHS≥5, were risk factors for mortality among premature infants with critical CHD.
Editorial
Neonatology (Perinatology)
Utility of neonatal early-onset sepsis calculator in risk-based group B Streptococcus screening approach
Myo-Jing Kim
Clin Exp Pediatr. 2020;63(10):393-394.   Published online May 22, 2020
· Evaluation of the risk factors for early-onset sepsis (EOS) is important to optimal prevention and treatment.
· The EOS calculator is still valid as part of the risk-based group B Streptococcus (GBS) screening approach.
· The risk factor assessment using the EOS calculator is worth use before the introduction of universal GBS screening.
Risk factors for in-hospital mortality in premature infants with critical congenital heart disease
Jeonghee Shin
Clin Exp Pediatr. 2020;63(10):391-392.   Published online October 6, 2020
The incidence and mortality rates of critical congenital heart disease (CHD) are higher in preterm than in term infants. The risk factors for in-hospital mortality in premature infants with critical CHD are unclear. However, the mortality of preterm infants with critical CHD may be related to CHD complexity as well as gestational age, birth weight, the presence of prematurity-associated comorbidities, and the treatment itself.
Allergy
Should we prescribe montelukast to allergic pediatric patients?
Yong Mean Park
Clin Exp Pediatr. 2020;63(10):389-390.   Published online August 24, 2020
Review Article
Endocrinology
Air pollution and childhood obesity
Moon Young Seo, Shin-Hye Kim, Mi Jung Park
Clin Exp Pediatr. 2020;63(10):382-388.   Published online March 27, 2020
Questions: What are the possible effects of air pollution on the occurrence of childhood obesity and what are the mechanisms?
Finding: Epidemiologic studies suggest that air pollutants might act as obesogens in the pediatric population, and their possible mechanisms include oxidative stress, physical inactivity, and epigenetic modulation.
Meaning: This paper reviews updated information on air pollution, one of the modifiable environmental factors in childhood obesity.
Allergy
Montelukast use over the past 20 years: monitoring of its effects and safety issues
Yong Ju Lee, Chang-Keun Kim
Clin Exp Pediatr. 2020;63(10):376-381.   Published online February 5, 2020
Although the efficacy of montelukast is inferior to that of ICS, both physicians and parents prefer montelukast to ICSs.
EDN may be a useful biomarker for the treatment and monitoring of preschool children with asthma.
The US FDA requires boxed warning about serious neuropsychiatric events of montelukast, therefore, physicians should consider the benefits and risks of montelukast before prescribing it.
Clinical Note
Neonatology (Perinatology)
Management of the first newborn delivered by a mother with COVID-19 in South Korea
Eun-Kyung Lee, Won Duck Kim, Dong won Lee, Sang-Ah Lee
Clin Exp Pediatr. 2020;63(9):373-375.   Published online July 13, 2020
Question: How to manage the newborn born to the coronavirus disease 2019 (COVID-19) pregnant?
Finding: Medical staff managed the delivery and neonatal care of a COVID-19 pregnant patient was based on the “Guidelines for COVID-19 response.”
Meaning: We desire that our management will help treat for subsequent patients and there should be updated continuously the prevention and control consensus strategies for newborn COVID-19.
Original Article
Neurobehavior
Association between assisted reproductive technology and autism spectrum disorders in Iran: a case-control study
Ensiyeh Jenabi, Mahdieh Seyedi, Ronak Hamzehei, Saeid Bashirian, Mohammad Rezaei, Katayoon Razjouyan, Salman Khazaei
Clin Exp Pediatr. 2020;63(9):368-372.   Published online March 27, 2020
Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder defined by impairments in social interaction and verbal and nonverbal communication.
Purpose: Determine the association between use of assisted reproduction technology (ART) and the risk of ASD among children. Methods: This case-control study included 300 participants (100 cases, 200 controls). The control group included women with a child aged 2–10 years without ASD,...
Other
Evaluation of goodness of fit of semiparametric and parametric models in analysis of factors associated with length of stay in neonatal intensive care unit
Fatemeh Kheiry, Sadegh Kargarian-Marvasti, Sima Afrashteh, Abolfazl Mohammadbeigi, Nima Daneshi, Salma Naderi, Seyed Hossein Saadat
Clin Exp Pediatr. 2020;63(9):361-367.   Published online June 10, 2020
Question: Hospitalization in neonatal intensive care unit (NICU) is associated with life-threatening hazards. What factors associated with neonatal length of stay (LOS) in the NICU?
Finding: Breastfeeding, phototherapy, acute renal failure (ARF), mechanical ventilation, and central venous catheter (CVC) access were identified as factors associated with NICU length of stay.
Meaning: Protective effects of breastfeeding and CVC access, whereas increase effects of phototherapy, ARF, and mechanical ventilation in LOS can be supporting evidence to establish effective interventions to reduce length of NICU stay.
Editorial
Infection
What are considerations for neonates at risk for COVID-19?
Soo-Han Choi
Clin Exp Pediatr. 2020;63(9):359-360.   Published online July 17, 2020
Neonatology (Perinatology)
Survival model application for analysis of neonatal length of stay
Eun Joo Lee
Clin Exp Pediatr. 2020;63(9):357-358.   Published online May 14, 2020
Gastroenterology
Dietary role in the development and treatment of inflammatory bowel disease
Jae Young Kim
Clin Exp Pediatr. 2020;63(9):355-356.   Published online July 13, 2020
Although the precise pathogenesis of inflammatory bowel disease (IBD) is unclear, dietary factors seem to play a significant role. Dietary modifications including enteral nutrition and the Crohn disease exclusion, specific carbohydrate, and anti-inflammatory diets show a potential ability to downregulate gut inflammation. These nutritional interventions have various degree of efficacies with limited side effects profile for treating pediatric IBD, but data from randomized prospective studies are lacking, and further studies are warranted.
Review Article
Pulmonology
Overview of management of children with COVID-19
Dyah Kanya Wati, Arya Krisna Manggala
Clin Exp Pediatr. 2020;63(9):345-354.   Published online July 17, 2020
The specific treatments for COVID-19 in children remain inconclusive and debatable despite effectively decreasing its signs and symptoms.
The need for clinical trials and reports should be investigated.
Gastroenterology
Increasing incidence of inflammatory bowel disease in children and adolescents: significance of environmental factors
Sowon Park, Yunkoo Kang, Hong Koh, Seung Kim
Clin Exp Pediatr. 2020;63(9):337-344.   Published online December 6, 2019
Inflammatory bowel disease (IBD) is a chronic relapsing immune-mediated disease of the intestinal tract. Although its prevalence is reportedly lower in Asia than in Western countries, the rapid increase in the incidence of IBD has drawn attention to its etiology, including genetic susceptibility and environmental factors. Specifically, recent studies concerning dietary treatments and intestinal microbiota suggest that these factors may...
Perspective
Infection
Can we get a clue for the etiology of Kawasaki disease in the COVID-19 pandemic?
Jong-Woon Choi
Clin Exp Pediatr. 2020;63(9):335-336.   Published online July 13, 2020
A new coronavirus disease 2019 (COVID-19) has been spreading globally since December 2019. Children with a Kawasaki disease (KD)-like illness related with COVID-19 have been reported in Europe and the United States. They presented with symptoms of KD with or without cardiac abnormalities or shock, showing manifestations of hyperactive proinflammatory cytokine reactions like KD. Such cases may provide the opportunity for us to learn more about the etiology and pathogenesis of KD.
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