Clinical and Experimental Pediatrics

Original Article

Gastroenterology

Risk factors of prolonged diarrhea in children under 2 years old

Dedy Rahmat, Agus Firmansyah, Ina S. Timan, Saptawati Bardosono, Joedo Prihartono, Pramita Gayatri

Clin Exp Pediatr. 2023;66(12):538-544. Published online November 16, 2023

Question: What are the risk factors for prolonged diarrhea in children under 2 years old?
Finding: History of antibiotic use, zinc deficiency, and elevated fecal alpha-1 antitrypsin levels were the main risk factors of prolonged diarrhea in children under 2 years old with acute diarrhea.
Meaning: Rational antibiotic usage is necessary as well as thorough testing of serum zinc level and fecal alpha-1 antitrypsin levels.

DOI: https://doi.org/10.3345/cep.2023.00668

General Pediatrics

Virtual reality for pain reduction during intravenous injection in pediatrics: a systematic review and meta-analysis of controlled clinical trials

Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Masoud Rafiee, Mozhdeh Bashirian

Clin Exp Pediatr. 2023;66(12):533-537. Published online June 14, 2023

Web of Science 3 Crossref 4

Question: This is the first meta-analysis to examine published evidence of the effectiveness of virtual reality at reducing pain during pediatric intravenous injections.
Finding: Our results suggest that virtual reality effectively reduces pain associated with intravenous injections in pediatric patients.
Meaning: These findings suggest the importance of virtual reality in decreasing the pain of intravenous injections among children.

DOI: https://doi.org/10.3345/cep.2022.01193

Editorial

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

DOI: https://doi.org/10.3345/cep.2023.00899

Review Article

Endocrinology

Applications of genomic research in pediatric endocrine diseases

Ja Hye Kim, Jin-Ho Choi

Clin Exp Pediatr. 2023;66(12):520-530. Published online June 14, 2023

Web of Science 1 Crossref 1

· Recent advances in molecular genetics have improved our understanding of pediatric endocrine disorders and are now used in mainstream medical practice.
· Genome-wide association studies can increase our understanding of the biological mechanisms of disease and inform new therapeutic options.
· The identification of founder mutations leads to the efficient localization of the genes underlying Mendelian disorders.
· Next-generation sequencing technologies benefit clinical practice and research of pediatric endocrinology.

DOI: https://doi.org/10.3345/cep.2022.00948

Nonalcoholic fatty liver disease and insulin resistance in children

Kyungchul Song, Ho-Seong Kim, Hyun Wook Chae

Clin Exp Pediatr. 2023;66(12):512-519. Published online January 9, 2023

Web of Science 19 Crossref 18

· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea.
· Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD.
· Insulin resistance is closely related to NAFLD.

DOI: https://doi.org/10.3345/cep.2022.01312

Allergy

Natural course of IgE-mediated food allergy in children

Kyunguk Jeong, Sooyoung Lee

Clin Exp Pediatr. 2023;66(12):504-511. Published online June 14, 2023

Web of Science 11 Crossref 14

· Dendritic, regulatory T, and regulatory B cells significantly contribute to the natural course of food allergy.
· Cow’s milk and hen’s egg allergies tend to resolve in earlier childhood but recent studies show that 50% of patients still persist into school age.
· The potential factors affecting the natural course of food allergy are age at diagnosis, symptom severity, sensitization status and its change rate, and external factors such as diet and interventions.
· There is a considerable possibility of food allergy outgrow if specific IgE levels are 2–5 kUA/L or less, but other factors such as age and recent symptoms should be considered together.
· With a clear understanding of the natural course of food allergy, pediatricians can provide appropriate assessment and interventions to our patients, and consequently can help patients overcome their food allergy and improve the social safety net.

DOI: https://doi.org/10.3345/cep.2022.01004

Letter to the Editor

Neonatology (Perinatology)

Association between feeding intolerance and intestinal dysbiosis in very premature infants

Putri Maharani Tristanita Marsubrin, Agus Firmansyah, Rinawati Rohsiswatmo, Zakiudin Munasir, Saptawati Bardosono, Safarina G. Malik, Yuditiya Purwosunu, Ina S. Timan, Tetty Yuniati, Maya Yulindhini

Clin Exp Pediatr. 2023;66(11):501-503. Published online October 24, 2023

DOI: https://doi.org/10.3345/cep.2023.00829

Original Article

Neonatology (Perinatology)

Association between maternal coronavirus disease 2019 and transient tachypnea of the newborn: a single-center study

Sung Hee Lee, Ju Hyun Jin, Jong Ha Yoo, Shin Won Yoon

Clin Exp Pediatr. 2023;66(11):493-500. Published online October 24, 2023

Web of Science 3 Crossref 3

Question: What are the adverse clinical outcomes of neonates of coronavirus disease 2019 (COVID-19)–infected mothers?
Finding: Infants of mothers with COVID-19 were at significantly increased risk of transient tachypnea of the newborn (TTN), use of noninvasive ventilation, and need for supplemental oxygen (P<0.05).
Meaning: Neonates of mothers with COVID-19 are at risk of TTN and require respiratory support. Close monitoring is essential to ensuring timely intervention if required.

DOI: https://doi.org/10.3345/cep.2023.00563

Developmental and Behavioral Medicine

Attention-deficit/hyperactive-impulsive disorder symptoms among grade 1 students with reading disorder in Thailand

Patcharapun Sarisuta, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho

Clin Exp Pediatr. 2023;66(11):485-492. Published online October 24, 2023

Crossref 2

Question: Would students with reading disorder have a significantly higher prevalence of attention-deficit/hyperactiveimpulsive disorder (ADHD) symptoms than neurotypical students?
Finding: Students at risk of reading disorder exhibited significant ADHD symptoms compared with those not at risk of reading disorder according to all presentations of teacher assessments versus only for predominantly inattentive presentations of the parental assessments.
Meaning: Students with reading disorder have a significantly higher prevalence of ADHD symptoms than neurotypical students. Sex, parental education level, average family income, and children’s school affiliation significantly influenced reading disorder prevalence.

DOI: https://doi.org/10.3345/cep.2023.00773

Gastroenterology

Inferior vena cava to aorta ratio in dehydrated pediatric patients: a systematic review and meta-analysis

Gilbert Sterling Octavius, Michelle Imanuelly, Johan Wibowo, Nadia Khoirunnisa Heryadi, Melanie Widjaja

Clin Exp Pediatr. 2023;66(11):477-484. Published online June 14, 2023

Web of Science 2 Crossref 2

Question: The inferior vena cava to aorta (IVC/Ao) ratio measured via ultrasound has been touted as a promising noninvasive technique to assess clinically significant dehydration in pediatric patients.
Finding: Our meta-analysis found that IVC/Ao ratio had a positive likelihood ratio of 3.2 (95% confidence interval [CI], 2.1–5.1) and negative likelihood ratio of 0.18 (95% CI, 0.12–0.28).
Meaning: Hence, IVC/Ao ratio is insufficient to exclude or confirm significant dehydration in pediatric patients.

DOI: https://doi.org/10.3345/cep.2022.01445

Editorial

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.

DOI: https://doi.org/10.3345/cep.2023.00745

Review Article

Pulmonology

Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies

Eun Kyo Ha, Ju Hee Kim, Man Yong Han

Clin Exp Pediatr. 2023;66(11):465-474. Published online June 19, 2023

Web of Science 16 Crossref 20

· Current definitions of long coronavirus disease (COVID) in children and adolescents vary in duration, ranging from 4 to 12 weeks or more.
· The clinical spectrum of long COVID in children and adolescents comprises a wide range of symptoms and might be a multisystem disorder.
· Persistent health problems with a prevalence of 1%–66.5% were reported in children and adolescents after COVID-19, with a higher incidence of persistent single or multiple symptoms.

DOI: https://doi.org/10.3345/cep.2023.00472

Developmental and Behavioral Medicine

Spontaneous movements as prognostic tool of neurodevelopmental outcomes in preterm infants: a narrative review

Hyun Iee Shin, Myung Woo Park, Woo Hyung Lee

Clin Exp Pediatr. 2023;66(11):458-464. Published online May 16, 2023

Web of Science 3 Crossref 3

· Spontaneous movements can be useful to evaluate neuronal integrity in preterm infants.
· In General Movements Assessment, continuous cramped synchronized movements and absent fidgety movements can indicate high-risk infants for cerebral palsy.
· Recent advances in machine learning techniques have led to the automated prediction of cerebral palsy based on infantile spontaneous movements.

DOI: https://doi.org/10.3345/cep.2022.01235

Letter to the Editor

Allergy

Increased serum eosinophilic cationic protein in children with nonspecific chronic cough

Young Hwan Kim, Yoon Young Jang, Jieun Jeong, Hai Lee Chung

Clin Exp Pediatr. 2023;66(10):455-457. Published online September 14, 2023

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2023.00416

Original Article

Developmental and Behavioral Medicine

Impact of short and intensive art-based intervention on symptomatology and social interactions among children with autism spectrum disorder

Deldar Morad Abdulah, Bayar Mohammed Omar Abdulla, Pranee Liamputtong

Clin Exp Pediatr. 2023;66(10):447-454. Published online September 14, 2023

Web of Science 2 Crossref 3

Question: Does a short and intensive art-based intervention affect symptoms and social interactions among children with autism spectrum disorder (ASD)?
Finding: The short and intensive art-based intervention did not affect symptoms in children with ASD level 2 or 3, including social awareness, social cognition, social communication, social motivation, and autistic mannerisms.
Meaning: The short and intensive art-based intervention did not improve the symptoms of patients with ASD.

DOI: https://doi.org/10.3345/cep.2023.00640

Neonatal risk factors associated with attention-deficit/hyperactivity disorder: an umbrella review

Ensiyeh Jenabi, Erfan Ayubi, Sajjad Farashi, Saeid Bashirian, Fereshteh Mehri

Clin Exp Pediatr. 2023;66(10):441-446. Published online July 14, 2023

Web of Science 1 Crossref 1

Question: The risk factors for attention deficit hyperactivity disorder (ADHD), such as breastfeeding, congenital heart disease, and low birth weight, in neonates are not well understood.
Finding: This umbrella review obtained significant effect sizes for ADHD for congenital heart disease (odds ratio [OR], 3.04), low birth weight (OR, 2.25), never breastfed (OR, 1.55), and Apgar score (OR, 1.30).
Meaning: Congenital heart disease, low birth weight, lack of breastfeeding, and Apgar scores were significant factors for ADHD.

DOI: https://doi.org/10.3345/cep.2022.01396

Editorial

Immunology

Systemic autoinflammatory disorders: autoinflammatory and autoimmune disorders

Young Dae Kim

Clin Exp Pediatr. 2023;66(10):439-440. Published online July 4, 2023

Web of Science 5 Crossref 6

· 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.

DOI: https://doi.org/10.3345/cep.2023.00605

Review Article

Immunology

Systemic autoinflammatory disorders

Dae Chul Jeong

Clin Exp Pediatr. 2023;66(10):432-438. Published online June 14, 2023

Web of Science 4 Crossref 5

· Systemic autoinflammatory disorders (SAID) are disorders caused by dysregulation of the innate immunity with genetic background, leading to recurrent episodes of systemic inflammation.
· SAID is characterized by recurrent acute inflammatory responses including fever or skin manifestations, unrelated with infection or malignancy.
· Diagnosis is based on family and long-term history with detailed clinical and laboratory manifestations during febrile periods.

DOI: https://doi.org/10.3345/cep.2022.01186

Nephrology (Genitourinary)

Kidney complications associated with COVID-19 infection and vaccination in children and adolescents: a brief review

Hee Sun Baek, Min Hyun Cho

Clin Exp Pediatr. 2023;66(10):424-431. Published online June 28, 2023

Web of Science 4 Crossref 4

Several observational studies have shown that acute kidney injury affects up to 46% of children and adolescents who develop severe postinflammatory responses, such as multisystem inflammatory syndrome in childhood, due to coronavirus disease 2019 (COVID-19). Although causality has not been established, some cases of glomerulopathy or nephrotic syndrome occurring after COVID-19 infection or vaccination have been reported. Therefore, kidney complications associated with these conditions in children and adolescents warrant attention.

DOI: https://doi.org/10.3345/cep.2023.00738

Infection

Safety monitoring of COVID-19 vaccines: February 26, 2021, To June 4, 2022, Republic of Korea

Yeon-Kyeng Lee, Yunhyung Kwon, Yesul Heo, Eun Kyoung Kim, Seung Yun Kim, Hoon Cho, Seontae Kim, Mijeong Ko, Dosang Lim, Soon-Young Seo, Enhi Cho

Clin Exp Pediatr. 2023;66(10):415-423. Published online June 13, 2023

Web of Science 2 Crossref 2

· Enhanced safety monitoring system of coronavirus disease 2019 (COVID-19) vaccines were implemented to detect signals rapidly as part of the national COVID-19 vaccination program.
· As of June 4, 2023, reported adverse events after COVID-19 vaccination was 0.38% among 125,107,883 doses of COVID- 19 vaccines administered.
· Most reported adverse reactions after COVID-19 vaccinations have shown nonserious and mild intensity.

DOI: https://doi.org/10.3345/cep.2022.00815

Correspondence

Cardiology

The authors reply: Age-, sex-, and height-based blood pressure reference charts, Yazd children 6–18 years, Iran

Seyedeh Mahdieh Namayandeh, Nastran Ahmadi, Seyed Mahmood Sadr

Clin Exp Pediatr. 2023;66(9):414-414. Published online June 14, 2023

DOI: https://doi.org/10.3345/cep.2021.01312

General Pediatrics

Letter to the editor: Age-, sex-, and height-based blood pressure reference charts, Yazd children 6-18 years, Iran

Amar Taksande

Clin Exp Pediatr. 2023;66(9):412-413. Published online October 27, 2021

DOI: https://doi.org/10.3345/cep.2020.02103

Original Article

Critical Care Medicine

Timing of parenteral nutrition initiation in critically ill children: a randomized clinical trial

Nagwan Y. Saleh, Hesham M. Aboelghar, Nehad B. Abdelaty, Mohamed I. Garib, Asmaa A. Mahmoud

Clin Exp Pediatr. 2023;66(9):403-411. Published online June 14, 2023

Web of Science 3 Crossref 4

Question: What is the ideal initiation timing of parenteral nutrition for critically ill children?
Finding: This randomized clinical trial of 140 children examined the effects of an early or late start of parenteral nutrition on mechanical ventilation need (primary outcome) and length of stay and mortality (secondary outcomes).
Meaning: Children who received early versus late parenteral nutrition had lower mechanical ventilation need and duration.

DOI: https://doi.org/10.3345/cep.2023.00178

Gastroenterology

Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome

Ozlem Kara, Hanife Aysegul Arsoy, Murat Keskin

Clin Exp Pediatr. 2023;66(9):395-402. Published online June 14, 2023

Web of Science 7 Crossref 5

Question: Is polycystic ovary syndrome (PCOS) a risk factor for nonalcoholic fatty liver disease (NAFLD) in adolescents?
Finding: The frequency of NAFLD did not increase in adolescents with PCOS. However, hyperandrogenemia was a risk factor for NAFLD.
Meaning: Adolescents with PCOS and hyperandrogenemia should be closely monitored for hepatic steatosis.

DOI: https://doi.org/10.3345/cep.2023.00353

Review Article

Neonatology (Perinatology)

Treatment of congenital cytomegalovirus infection

Gyu Hong Shim

Clin Exp Pediatr. 2023;66(9):384-394. Published online December 28, 2022

Web of Science 6 Crossref 8

· Congenital cytomegalovirus (CMV) infection is among the most common causes of nongenetic sensorineural hearing loss.
· Congenital CMV is initially treated with intravenous ganciclovir for 2–6 weeks and switched to oral valganciclovir, or with oral valganciclovir for the entire 6-month period.
· Infants with congenital CMV require periodic monitoring of absolute neutrophil count, platelet count, and blood urea nitrogen, creatinine, liver function tests, audiological, ophthalmological, and developmental tests during antiviral medication.

DOI: https://doi.org/10.3345/cep.2022.01032

Gastroenterology

Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children

Yu Kyung Cho, Jin Lee, Chang Nyol Paik

Clin Exp Pediatr. 2023;66(9):377-383. Published online August 21, 2023

Web of Science 5 Crossref 6

· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition.
· SIBO is prevalent in children and adolescents with functional abdominal pain disorders.
· Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria.
· Breath tests are safe and noninvasive.
· Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics.

DOI: https://doi.org/10.3345/cep.2022.00969

Other

Hearing loss in neonates and infants

Goun Choe, Su-Kyoung Park, Bong Jik Kim

Clin Exp Pediatr. 2023;66(9):369-376. Published online January 9, 2023

Web of Science 9 Crossref 10

· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates.
· Etiologies vary, and up to 80% of cases are genetic.
· Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention.

DOI: https://doi.org/10.3345/cep.2022.01011

Letter to the Editor

Infection

SARS-CoV-2 fecal shedding pattern in pediatric patients with acute COVID-19 or COVID-19-associated multisystem inflammatory syndrome

Setareh Mamishi, Fatemeh Jalali, Sepideh Benvari, Babak Pourakbari, Mohammad Reza Abdolsalehi, Reihaneh Hosseinpour Sadeghi, Mohammad Shahbabaie, Amene Navaeian, Shima Mahmoudi

Clin Exp Pediatr. 2023;66(8):366-368. Published online June 14, 2023

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2023.00297

Original Article

Allergy

Association between dyslipidemia and asthma in children: a systematic review and multicenter cohort study using a common data model

Ji Eun Lim, Hye Min Kim, Ju Hee Kim, Hey Sung Baek, Man Yong Han

Clin Exp Pediatr. 2023;66(8):357-365. Published online June 14, 2023

Web of Science 8 Crossref 7

Question: Is dyslipidemia a risk factor for asthma in children?
Finding: This was a comprehensive systematic review and retrospective multicenter study of the association between dyslipidemia and asthma in children. In a multicenter cohort analysis using the Observational Medical Outcomes Partnership Common Data Model, elevated total cholesterol levels were associated with increased risk of asthma development.
Meaning: These findings suggest an association between dyslipidemia and asthma in children.

DOI: https://doi.org/10.3345/cep.2023.00290

Neurology

Need for palliative care from birth to infancy in pediatric patients with neurological diseases

Raffaele Falsaperla, Silvia Marino, Carla Moscheo, Lucia Giovanna Tardino, Simona Domenica Marino, Concetta Sciuto, Piero Pavone, Giovanna Vitaliti, Federica Sullo, Martino Ruggieri

Clin Exp Pediatr. 2023;66(8):350-356. Published online June 14, 2023

Web of Science 2 Crossref 2

Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy?
Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis.
Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required.

DOI: https://doi.org/10.3345/cep.2023.00129

Cited By 25	Neurodevelopmental outcomes of preterm infants
Cited By 20	Association of gut microbiota with obesity in children and adolescents
Cited By 20	Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Cited By 19	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis
Cited By 18	Nonalcoholic fatty liver disease and insulin resistance in children

Article category