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Editorial
Other
Global trend and disparity of acute lower respiratory infection as cause of mortality in children under 5 years of age
Abdul Wahab
Clin Exp Pediatr. 2021;64(12):630-631.   Published online June 11, 2021
Acute lower respiratory infection (ALRI) is the leading cause of death among children under 5 years of age worldwide, especially in low- and middle-income countries. A spatial analysis explains the trends and severity based on the conditions of each country. Countries in Asia and Africa experience many cases of mortality caused by ALRI.
Neurology
Recent studies are focus on the new treatments for hypoxicischemic encephalopathy (HIE) and long-term outcomes in later childhood and adolescence in children with a history on HIE
Eun Sook Suh
Clin Exp Pediatr. 2021;64(12):628-629.   Published online September 30, 2021
Neonatal encephalopathy is the most important reason for morbidity and mortality. The early detection of neonate with high risk for hypoxic ischemic encephalopathy (HIE) and treatment are important for prevent long term complication. Hypothermia is currently standard treatment option for HIE. Several clinical studies have been performed due to improve the long term outcome. New therapeutic options including xenon, allopurinol, erythropoietin, topiramate will help to reduce neuropsychiatric disability.
Review Article
Endocrinology
Endocrine comorbidities of pediatric obesity
Jieun Lee, Jae Hyun Kim
Clin Exp Pediatr. 2021;64(12):619-627.   Published online August 26, 2021
∙ Pediatric obesity can involve endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty.
∙ Prediabetes and type 2 diabetes in youth aged 10–19 years had a prevalence of 25.9% and 0.6% in 2013–2014, respectively.
∙ Dyslipidemia in Korean adolescents aged 10–18 years had a prevalence of 7.64% (total cholesterol ≥200 mg/dL), 6.09% (low-density lipoprotein cholesterol ≥130 mg/dL), 8.69% (triglyceride ≥150 mg/dL), and 12.52% (high-density lipoprotein cholesterol ≤40 mg/dL) in 2007–2018.
∙ Metabolic syndrome in Korean youth has a prevalence of 1.9%–14.7% in males and 1.7%–12.6% in females with wide variation in definitions.
∙ Appropriate comorbidity screening and management and/or specialist referral are necessary for obese children and adolescents.
Neurology
Cognitive outcomes in late childhood and adolescence of neonatal hypoxic-ischemic encephalopathy
Bo Lyun Lee, Hannah C. Glass
Clin Exp Pediatr. 2021;64(12):608-618.   Published online May 24, 2021
∙ Cognitive impairments occur in children with hypoxic-ischemic encephalopathy (HIE) even without neuromotor deficits.
∙ Therapeutic hypothermia has improved neurodevelopmental outcomes of children with HIE; however, 40% of children remain at risk of death/disability or cognitive impairments necessitating the development of adjunctive neuroprotective therapies.
∙ Long-term follow-up until adolescence is required to identify cognitive dysfunction.
∙ A pattern of watershed injury on brain imaging is associated with poor cognitive outcomes.
Infection
Recommendation for use of diphtheria and tetanus toxoids and acellular pertussis, inactivated poliovirus, Haemophilus influenzae type b conjugate, and hepatitis B vaccine in infants
Hye-Kyung Cho, Su Eun Park, Yae-Jean Kim, Dae Sun Jo, Yun-Kyung Kim, Byung-Wook Eun, Taek-Jin Lee, Jina Lee, Hyunju Lee, Ki Hwan Kim, Eun Young Cho, Jong Gyun Ahn, Eun Hwa Choi; The Committee on Infectious Diseases of the Korean Pediatric Society
Clin Exp Pediatr. 2021;64(12):602-607.   Published online June 8, 2021
∙ Diphtheria and tetanus toxoids and acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) was licensed in Korea in April 2020.
∙ DTaP-IPV-Hib-HepB is indicated as a 3-dose primary series for infants aged 2, 4, and 6 months who received the standalone HepB vaccine at birth.
∙ Infants born to HepB surface antigen-positive mothers are currently recommended to be immunized with HepB immunoglobulin at birth and then monovalent HepB vaccine at 0, 1, and 6 months.
Letter to the Editor
Infection
Multisystem inflammatory syndrome in children and Kawasaki disease in infants: 2 sides of the same coin?
Hing Cheong Kok, Dinesh Nair, Ke Juin Wong, Siew Moy Fong
Clin Exp Pediatr. 2021;64(11):599-601.   Published online October 7, 2021
Question: Are multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) in infants, 2 sides of the same coin?
Finding: Here we report on a 4-month-old girl with MIS-C and signs of KD with shock. Most (83%) infants with MIS-C had features of KD, especially KD shock syndrome.
Meaning: MIS-C is similar to KD, and likely is a consequence of dysregulated immune responses secondary to sudden acute respiratory syndrome coronavirus 2 infection.
Clinical Note
Infection
A neonate infected with coronavirus disease 2019 with severe symptoms suggestive of multisystem inflammatory syndrome in childhood
Fatemeh Eghbalian, Ghazal Sami, Saeid Bashirian, Ensiyeh Jenabi
Clin Exp Pediatr. 2021;64(11):596-598.   Published online September 10, 2021
Question: Can multisystem inflammatory syndrome in childhood (MIS-C) occur in the neonate associated with coronavirus disease 2019 (COVID-19)?
Finding: A 9-day-old neonate infected with COVID-19 had fever, respiratory distress, and gastrointestinal symptoms suggestive of MIS-C. This neonate recovered after treatment with intravenous immunoglobulin (IVIG).
Meaning: IVIG successfully treated a rare case of a 9-day-old neonate with COVID-19 and severe symptoms suggestive of MIS-C.
Original Article
General Pediatrics
Risk factors for childhood pneumonia: a case-control study in a high prevalence area in Indonesia
Vivi Ninda Sutriana, Mei Neni Sitaresmi, Abdul Wahab
Clin Exp Pediatr. 2021;64(11):588-595.   Published online March 15, 2021
Question: Is the incidence of childhood pneumonia influenced by breastfeeding and basic immunization status?
Finding: Exclusive breastfeeding and complete basic immunization status have an effect in limiting the incidence of childhood pneumonia.
Meaning: While exclusive breastfeeding and complete basic immunization the Expanded Program on Immunization status are important factors for reducing the incidence of childhood pneumonia, indoor air pollution was also a significant risk factor.
Cardiology
Assessment of cardiac function in syncopal children without organic causes
Heoungjin Kim, Lucy Youngmin Eun
Clin Exp Pediatr. 2021;64(11):582-587.   Published online March 10, 2021
Question: Does a subtle deterioration in cardiac function affect the severity of syncope in patients without underlying disease?
Finding: For syncope patients with reasonable cardiac function but without underlying disease, tissue Doppler imaging (TDI) measurements helped reveal subtle differences in cardiac function with syncope and predicted the severity of syncope or a potential recurrent event.
Meaning: TDI measurements might be a useful indicator for predicting the severity of syncope.
Original article
Infection
The global prevalence of Toxocara spp. in pediatrics: a systematic review and meta-analysis
Behnam Abedi, Mehran Akbari, Sahar KhodaShenas, Alireza Tabibzadeh, Ali Abedi, Reza Ghasemikhah, Marzieh Soheili, Shnoo Bayazidi, Yousef Moradi
Clin Exp Pediatr. 2021;64(11):575-581.   Published online February 5, 2021
Is the global prevalence of toxocariasis high among children? The prevalence of toxocariasis is high in pediatric patients. Asian children are more susceptible to the disease than other children. Its virulence varies among different socioeconomic classes in various countries. Hand washing after soil contact, routine pet deworming, and appropriate disposal of pet feces in households with Asian pediatrics are needed to prevent toxocariasis.
Editorial
Oncology
Infantile hemangioma: timely diagnosis and treatment
Meerim Park
Clin Exp Pediatr. 2021;64(11):573-574.   Published online July 22, 2021
While the majority of infantile hemangiomas (IHs) do not require therapy and regress spontaneously, about 10%–15% develop complications such as ulceration, obstruction, or disfigurement. Early intervention is recommended for infants with potentially problematic IHs. Oral propranolol 2–3 mg/kg/day is currently the treatment of choice.
Review Article
Oncology
Update on infantile hemangioma
Hye Lim Jung
Clin Exp Pediatr. 2021;64(11):559-572.   Published online May 26, 2021
· Infantile hemangiomas (IHs) are the most common benign vascular tumors, occurring in 5%–10% of infants.
· IHs are characteristically not present at birth but are usually diagnosed at 1–4 weeks of age, rapidly proliferate until 5 months of age, and then spontaneously involute.
· High-risk IHs (10%) require early treatment from 1 month of age.
· Oral propranolol, a nonselective beta-blocker, is the first-line treatment for IHs.
Nutrition
Changes in health status of North Korean children and emerging health challenges of North Korean refugee children
Seong-Woo Choi
Clin Exp Pediatr. 2021;64(11):552-558.   Published online May 17, 2021
· Among North Korean refugee (NKR) children under 5 years, 61% and 9.3% were underweight in 1998 and 2017, respectively.
· The immunization rate of NKR children exceeded 90% since 2006.
· For NKR children, protein-energy malnutrition was the #1 cause of death in 2009 versus #17 in 2019.
· In 2020, stunting affected 5.4% and 0.9% and obesity affected 10.7% and 2.7% of NKR versus South Korean children, respectively.
Infection
Effects of nasopharyngeal microbiota in respiratory infections and allergies
Hyun Mi Kang, Jin Han Kang
Clin Exp Pediatr. 2021;64(11):543-551.   Published online April 15, 2021
· The nasal microbiota varies with age and is shaped by various factors in healthy individuals.
· The pathological condition of the respiratory tract appears to be associated with reduced nasal microbiota biodiversity, while dysbiosis is involved in the pathophysiology of many respiratory diseases, including otitis, sinusitis, allergic diseases, and lower respiratory infections.
Original Article
Psychiatric/Psychology
Association between small for gestational age and risk of autism spectrum disorders: a meta-analysis
Ensiyeh Jenabi, Saeid Bashirian, Zahra Asali, Mahdieh Seyedi
Clin Exp Pediatr. 2021;64(10):538-542.   Published online January 28, 2021
• The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) and remains conflicting.
• We showed based on odds ratio reports in epidemiological studies that SGA can increase the risk of ASD and SGA is a risk factor for ASD.
• The association between SGA and the risk of ASD has further momentum to the current public health emphasis on appropriate prepregnancy weight and weight gain during pregnancy
Other
Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital
Muruganantham Balagurunathan, Thrilok Natarajan, Jothilakshmi Karthikeyan, Venkateshwaran Palanisamy
Clin Exp Pediatr. 2021;64(10):531-537.   Published online August 4, 2021
Question: What are the clinical spectrum, course, and short-term outcomes of multisystem inflammatory syndrome in children (MIS-C)?
Finding: MIS-C can have variable clinical manifestations. Fever is most common, followed by gastrointestinal and cardiovascular symptoms. Early identification and appropriate management lead to favorable outcomes.
Meaning: MIS-C can present in a myriad of ways and severities. High suspicion is necessary to ensure its early identification and appropriate management and favorable patient outcomes.
Endocrinology
Correlation between total air pollutant emissions and incidence of type 1 diabetes in the Russian Federation
Hoon Sung Choi, Jin Taek Kim, Ji-Young Seo, Faina Linkov, Evgeniy Shubnikov, Hong Kyu Lee
Clin Exp Pediatr. 2021;64(10):525-530.   Published online January 18, 2021
Question: Is there a quantitative relationship between air pollutant emissions and the incidence of type 1 diabetes (T1D)?
Finding: The incidence of T1D in each region of the Russian Federation correlated with the total air pollutants emitted each year.
Meaning: These findings suggest that air pollution contributes to the development of T1D.
Editorial
Endocrinology
Ambient air pollution and pediatric diabetes
Jae Hyun Kim
Clin Exp Pediatr. 2021;64(10):523-534.   Published online March 12, 2021
· Epidemiological studies have shown that ambient air pollution is associated with diabetes mellitus in children and adults.
· The mechanism of ambient air pollution causing diabetes mellitus is unclear.
· A study of the association between diabetes and air pollution in Korean pediatric populations is required.
Nephrology (Genitourinary)
Obesity and chronic kidney disease: what should pediatric nephrologists know?
Jung Won Lee
Clin Exp Pediatr. 2021;64(10):521-522.   Published online June 1, 2021
• Obesity is not only a comorbidity of hypertension, it may be a riskfactorfor chronickidneydisease.
• Renal impairment associated with obesity is believed to start early in childhood and continue into adulthood, implying a higher risk of adverse cardiovascular events.
• The identification of kidney injury, implementation of preventive strategies, and prompt treatment are essential to improving clinical outcomes in obese children with early kidney disease.
Immunology
Importance of neonatal screening for primary immunodeficiencies
Jung Woo Rhim
Clin Exp Pediatr. 2021;64(10):519-520.   Published online May 4, 2021
· Early detection of asymptomatic infants with primary immunodeficiencies before the onset of infections enables effective treatment and intervention to prevent serious sequelae.
· T-cell receptor excision circles and kappa-deleting recombination excision circles have recently been used to detect T- or B-cell lymphopenia in neonates.
Review Article
Nephrology (Genitourinary)
Obesity and chronic kidney disease: prevalence, mechanism, and management
Hyung Eun Yim, Kee Hwan Yoo
Clin Exp Pediatr. 2021;64(10):511-518.   Published online April 6, 2021
· Obesity is strongly associated with the development and progression of chronic kidney disease.
· Altered renal hemodynamics, metabolic effects, and lipid nephrotoxicity may play a key role in the development of obesity-related kidney disease.
· Children born to obese mothers are at increased risk of developing obesity and chronic kidney disease later in life.
· A multilevel approach is needed to prevent obesity and related chronic diseases.
Immunology
Modern diagnostic capabilities of neonatal screening for primary immunodeficiencies in newborns
Evgenia Olegovna Khalturina, Natalia Dmitrievna Degtyareva, Anastasiia Vasi’evna Bairashevskaia, Alena Valerievna Mulenkova, Anna Vladimirovna Degtyareva
Clin Exp Pediatr. 2021;64(10):504-510.   Published online March 25, 2021
· Neonatal screening for primary immunodeficiency diseases (PIDs) enables early diagnosis and subsequent initiation of therapy.
· Excision of T-cell receptors and kappa-recombination excision circles are cheaper alternative PID screening methods.
· Sanger DNA sequencing remains the reference method for detecting PID; however, next-generation sequencing technology is increasingly used to diagnose it.
· Here we developed a graphical algorithm for diagnosing primary immunodeficiency syndrome based on modern methods of screening for primary immunodeficiencies in newborns.
Neurology
Recent update on reading disability (dyslexia) focused on neurobiology
Sung Koo Kim
Clin Exp Pediatr. 2021;64(10):497-503.   Published online March 2, 2021
·Neurobiological studies using functional brain imaging have uncovered the reading pathways, brain regions involved in reading, and neurobiological abnormalities of dyslexia.
·An accurate diagnosis and timely specialized intervention are important in children with dyslexia. When national infant development screening tests have been conducted as in Korea, if a language developmental delay and early predictors of dyslexia are detected, the progression to dyslexia should be carefully observed and early intervention provided.
Letters to the Editor
Gastroenterology
Functional gastrointestinal disorders and smartphone use in adolescents
Mauro Cinquetti, Marco Biasin, Marco Ventimiglia, Linda Balanzoni, Denise Signorelli, Angelo Pietrobelli
Clin Exp Pediatr. 2021;64(9):494-496.   Published online November 9, 2020
Question: Are functional gastrointestinal disorders (FGIDs) common in Italy? If so, what are the associated risk factors?
Finding: In this cross-sectional study of 1,594 adolescents, the prevalence of FGIDs was 30.9% and was mainly associated with smartphone addiction.
Meaning: Smartphone use and dietary habits should be monitored in children with FGIDs.
Original Article
Psychiatric/Psychology
Is there an association between labor induction and attention-deficit/hyperactivity disorder among children?
Ensiyeh Jenabi, Mahdieh Seyedi, Saeid Bashirian, Bita Fereidooni
Clin Exp Pediatr. 2021;64(9):489-493.   Published online February 5, 2021
· This meta-analysis pooled all observational (case-control and cohort) studies to obtain the association between labor induction and the risk of attention-deficit/hyperactivity disorder (ADHD) among children.
· The findings showed that labor induction is not associated with increased risk of ADHD among children.
Allergy
Cohort profile: National Investigation of Birth Cohort in Korea study 2008 (NICKs-2008)
Ju Hee Kim, Jung Eun Lee, So Min Shim, Eun Kyo Ha, Dong Keon Yon, Ok Hyang Kim, Ji Hyeon Baek, Hyun Yong Koh, Kyu Young Chae, Seung Won Lee, Man Yong Han
Clin Exp Pediatr. 2021;64(9):480-488.   Published online January 5, 2021
This national cohort study included all Korean children born in 2008 and 2009 observed over a period of more than 10 years. Our findings demonstrate that it is possible to analyze disease onset prior to hospitalization based on information such as lifestyle, eating habits, and risk factors by integrating National Health Insurance System data with national health screening data.
Nutrition
Impact of preoperative nutritional status on surgical outcomes in patients with pediatric gastrointestinal surgery
Nehal El Koofy, Hadeer Mohamed Nasr Eldin, Wesam Mohamed, Mostafa Gad, Sara Tarek, Gamal El Tagy
Clin Exp Pediatr. 2021;64(9):473-479.   Published online November 16, 2020
Question: Is malnutrition a risk factor for postoperative complications in pediatric surgical patients?
Finding: There is a high incidence of malnutrition in pediatric surgical patients. Stunting increases the risks of postoperative complications and extended hospital stays, while underweight status contributes to extended hospital stays.
Meaning: Preoperative nutritional assessments are crucial to improving postoperative outcomes. Anemia increases the risk of postoperative complications and should be corrected preoperatively.
Editorial
Gastroenterology
Does smartphone overuse affect functional gastrointestinal disorders?
Jee Hyun Lee
Clin Exp Pediatr. 2021;64(9):471-472.   Published online December 28, 2020
Functional gastrointestinal disorders are common disorders characterized by persistent and recurrent gastrointestinal symptoms. Pathophysiological mechanisms have been suggested, including intestinal microbiota, altered intestinal permeability and motility, dietary effects, sensory abnormalities, and brain-gut dysregulation. Lifestyle factors such as diet, sleep, affect, and physical activity might function as moderators.
Nutrition
Advantages and limitations of using national survey datasets in child and adolescent research
Yoon Lee
Clin Exp Pediatr. 2021;64(9):468-470.   Published online January 26, 2021
The Korean National Health and Nutrition Examination Survey and the Korea Youth Risk Behavior Web-based Survey are major nationwide health and nutrition surveys in Korea. Although these surveys have some limitations of cross-sectional sample surveys, the accumulated data are valuable and provide new prospects for understanding public health depending on the interpretation method.
Review Article
Infection
Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia
Hye-Kyung Cho
Clin Exp Pediatr. 2021;64(9):459-467.   Published online February 10, 2021
• To avoid unnecessary exposure to secondary antibiotics, it is needed to diagnose Mycoplasma pneumoniae (MP) pneumonia carefully, especially when unresponsiveness to macrolide is suspected.
• Serologic and molecular tests for MP infection and excluding respiratory infection caused by other pathogens might be considered.
• It is necessary to continuously monitor antibiotic susceptibility of MP, and efforts to lower antibiotic pressure are required.
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