An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking. |
This systematic review summarizes convincing evidence that total energy expenditure (TEE) measured using the doubly labeled water technique increased with age from 1 to 18 years, while fat-free mass (FFM) increased with growth. TEE and in normal-weight participants, while physical activity level did not differ from that of normal-weight participants. |
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures. · Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections. · Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures. |
· Intussusception, the most common cause of small bowel obstruction in young children, has an overall incidence in Korea of 28.3 cases per 100,000 person-years. · Its cause is idiopathic inmost cases, although viral or bacterial gastroenteritis has beenpostulated as a cause. Approximately 4% of children have pathological lead points for intussusception, and Meckel’s diverticulum is the most common cause. · Intussusception in preterm infants is extremely rare. Older children (>5 years of age) are at increased risk of pathological lead points. |
· The etiology of Kawasaki disease (KD) is unclear, but its clinical, epidemiological, and pathophysiological characteristics are strongly associated with infectious diseases. · In the coronavirus disease 2019 pandemic era, viruses are attracting the most attention. Sudden acute respiratory syndrome coronavirus 2 infection causes various hyperinflammation in children that require differentiation from KD. · Immune responses in patients with KD may be induced by host cell damage. To effectively prevent and treat KD, the genetic background and immune responses of KD patients and triggering pathogens require identification. |
· Asthma in infants and preschoolers involves heterogeneous phenotypes. · Asthma diagnosis is based on symptom patterns, therapeutic responses, and the presence of risk factors with careful consideration of differential diagnosis. · Daily inhaled corticosteroid therapy remains the most effective strategy for managing persistent asthma symptoms irrespective of phenotype. · Future research, including genetic and molecular studies, is needed to develop a clear definition of asthma and personalized therapeutic approaches. |
The identification of the causative pathogens of community-acquired pneumonia and appropriate treatment and prevention can reduce mortality and the socioeconomic burden by reducing the medical expenses. The world has been in the coronavirus disease 2019 pandemic since 2020, and there is always a risk of continuous emergence and epidemic of new respiratory infectious diseases. Therefore, it is important to sustain a monitoring system for respiratory infectious diseases including pneumonia. |
It is important to evaluate its effectiveness at the national level and to determine the varicella vaccine schedule based on the evidence generated through the studies. |
In the early days of the coronavirus disease 2019 (COVID-19) pandemic, allergic diseases, especially asthma, were considered to be risk factors for severe COVID-19 infection, hospitalization, and death. These concerns stemmed from the idea that individuals with allergic diseases are generally more susceptible to respiratory virus infections, which are major causes of exacerbation of allergic diseases. However, epidemiologic data with... |
· Use conventional and amplitude-integrated electroencephalography to confirm clinical seizures and screen high-risk newborns. · Select an explicit clear elective event to be treated with less toxic and more effective antiepileptics. |
· Children with attention deficit hyperactivity disorder (ADHD) tend to have impaired motor performance that may affect their growth and development. · Although widely used among children with developmental disorders, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) is used sparsely among children with ADHD. · Assessment by the BOTMP increases our understanding of the motor repertoire of children with ADHD. · Wider usage of the BOTMP will enable more comprehensive planning of rehabilitation goals to enhance the motor abilities of children with ADHD. |
∙ Rotavirus infection-associated central nervous system (CNS) complications are fairly common in children. ∙ Common clinicoradiological features include benign convulsions with mild gastroenteritis, acute encephalopathies/encephalitis, cerebellitis, and neonatal rotavirus-associated leukoencephalopathy. ∙ Possible mechanisms for CNS complications include direct viral invasion into the brain via several potential routes such as the blood-brain barrier and vagus nerve, and entry of various brain-damaging mediators and activated immune cells into the brain. |
∙ The application of 3-dimensional (3D) printing in orthopedic oncology is summarized into bone and tumor modeling, patient-specific instruments (PSIs), custom-made implants, and tissue engineering. ∙ The 3D-printed customized implant is the most central application, while modeling and PSI often play adjunct roles. ∙ Short-term surgical outcomes of custom-made 3D-printed implants are promising. |
∙ The main pathogen for benign convulsions with mild gastroenteritis (CwG) was previously rotavirus; however, cases associated with norovirus are increasing. ∙ CwG is characterized by clustered generalized seizures. Electroencephalography and magnetic resonance imaging show transiently abnormal findings in the acute phase that eventually normalize with progression. Its prognosis is good, and long-term treatment is unnecessary. ∙ There are many reports on the pathophysiological mechanism of CwG, which remains unclear. |
∙ 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. |
∙ 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. |
∙ 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. |
· 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. |
· 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. |
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. |
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. |
∙ 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. |
∙ 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. |
· The innovation of healthcare information communication technology (ICT) was accelerated with the adoption of electronic health records (EHRs). · Telemedicine currently has no technical barriers. · EHRs and personal health records are being connected, and mobile/wearable technologies are being integrated into them. · Conventional rule-based clinical decision support systems have already been implemented and used in EHRs and PHRs. Artificial intelligence/machine learning improves precision and accuracy. |
The prevalence of Japanese pediatric hypertension is 0.9% based on proper measurement protocols. Hypertensive children tend to be hypertensive adults. Pediatric essential hypertension is characterized by an absence of symptoms, obesity, a family history of hypertension, and a low birth weight. The most common causes of pediatric secondary hypertension are renal parenchymal and renovascular diseases. Important factors controlling pediatric hypertension include healthy lifestyle modifications and pharmacotherapy. |
· Big data analysis, such as common data model and artificial intelligence, can solve relevant questions and improve clinical care. · Recent deep learning studies achieved 0.887–0.996 areas under the receiver operating characteristic curve for automated interictal epileptiform discharge detection. · Recent deep learning studies achieved 62.3%–99.0% accuracy for interictal-ictal classification in seizure detection and 75.0%– 87.8% sensitivity with a 0.06–0.21/hr false positive rate in seizure forecasting. |
· The need for data-driven modeling of multiomics interactions was recently highlighted. · Many artificial intelligence-driven models have been developed, but only a few have incorporated biological domain knowledge within model architectures or training procedures. · Here we provide a comprehensive review of deep learning models to decipher complex multiomics interactions regarding the biological guidance imposed upon them to facilitate further development of biological knowledge-guided deep learning models. |
· Myocarditis was recently examined quantitatively as inflammation of the heart muscle based on endomyocardial biopsy, and its noninvasive diagnosis remains unsatisfactory. · Additionally, numerous miRNAs (miR-155, miR-146b, miR-590, miR-221, miR-222, etc.) coupled with inflammation or viral activation have been examined in myocarditis patients or mouse models. · The recent identification of mmu-miR-721 (has-miR-Chr8: 96), a myocarditis-specific microRNA, demonstrated its potential as an acute myocarditis biomarker. |
· Childhood chronic kidney disease (CKD) is complex and requires lifetime medical treatment. · Children with CKD are at risk for emotional, behavioral, social, and academic difficulties that significantly affect their quality of life. · Caring for children with CKD is stressful for families. · These unique challenges are crucial and can negatively impact treatment outcomes. · Awareness of and addressing these evolving psychosocial issues can foster their developing needs. |
· Recently, the importance of a short-term treatment regimen including rifamycin has been highlighted in the treatment of latent tuberculosis infection (LTBI). · Four prospective or retrospective studies in children consistently reported that a 4-month daily rifampicin regimen (4R) had a higher completion rate than and comparable safety to a nine-month daily isoniazid regimen. · We suggest rifampicin 20–30 mg/kg/day for children aged 0–2 years and 15–20 mg/kg/day for children aged 2–10 years in 4R to treat LTBI. |