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- 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
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· 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
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· 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
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·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
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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
- Neurobehavior
- 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
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· 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
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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
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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
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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
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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
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• 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.
- Nutrition
- Dietary intake and nutritional status of Korean children and adolescents: a review of national survey data
- Minji Kang, So Yoon Choi, Minyoung Jung
- Clin Exp Pediatr. 2021;64(9):443-458. Published online December 28, 2020
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In Korea, several national cross-sectional surveys monitor the diet, nutritional status, and health status of children. This continual dedicated national surveillance system contributes to the identification of nutritional and health issues, establishment of public health policies, and development of nutrition recommendations. This paper provides recent information about the Korea National Health and Nutrition Examination Survey and the Korean Youth Risk...
- Critical Care Medicine
- Pediatric postintensive care syndrome: high burden and a gap in evaluation tools for limited-resource settings
- Chanapai Chaiyakulsil, Rapee Opasatian, Paweethida Tippayawong
- Clin Exp Pediatr. 2021;64(9):436-442. Published online December 18, 2020
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Pediatric postintensive care syndrome has high impact and burden and can affect a child’s life for decades. The early evaluation and detection of such problems require a simple and less time-consuming surveillance tool. Current evaluation tools can be difficult and strenuous for areas with limited resources. Thus, a new simple tool is required for the early detection and intervention of postintensive care syndrome in critically ill children
- Letter to the Editor
- General Pediatrics
- Skipping breakfast is associated with lifestyle habits among Japanese pupils
- Jun Kohyama
- Clin Exp Pediatr. 2021;64(8):433-435. Published online November 4, 2020
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Question: Breakfast is important; however, adolescents are increasingly skipping it.
Finding: Skipping breakfast is independently associated with sleepiness, physical inactivity, dinner irregularity, screen time on school days, poor academic performance, after-school activity, and decreased sleep duration before school day.
Meaning: Reducing screen time on school days, after-school activity, and irregular dinner habits might decrease breakfast skipping, resulting in decreased sleepiness and improved academic performance.
- Clinical note
- Nephrology (Genitourinary)
- Extracorporeal membrane oxygenation with systemic heparinization as a rescue therapy for acute life-threatening pulmonary thromboembolism complicating nephrotic syndrome
- Kyusang You, So Mi Kim, Dongmin Kim, Kyoungmin Ryu, Mee Jeong Lee
- Clin Exp Pediatr. 2021;64(8):430-432. Published online November 16, 2020
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Question: How would you treat acute life-threatening pulmonary thromboembolism occurring in nephrotic patients?
Finding: A 16-year-old woman with minimal change-associated nephrotic syndrome presented with cardiac arrest caused by an acute bilateral pulmonary thromboembolism. Her hemodynamics stabilized with resolution of thrombi while on venoarterial extracorporeal membrane oxygenation (ECMO) and systemic heparinization.
Meaning: In selected cases, ECMO with systemic heparinization may rescue patients from acute life-threatening pulmonary thromboembolism even without reperfusion therapy.
- Original Article
- Neonatology (Perinatology)
- Effects of carnosine and hypothermia combination therapy on hypoxic-ischemic brain injury in neonatal rats
- Jun Chul Byun, Seong Ryong Lee, Chun Soo Kim
- Clin Exp Pediatr. 2021;64(8):422-428. Published online February 24, 2021
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Question: How can we further improve the neuroprotective effects of hypothermia in newborns with hypoxic-ischemic (HI) brain injury?
Finding: Combination carnosine and hypothermia therapy effectively reduced brain damage in neonatal rats. The in situ zymography, terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling assay, and immunofluorescence study results showed that neuroprotective effects were achieved with combination therapy only.
Meaning: Carnosine and hypothermia have synergistic neuroprotective effects against brain damage following HI injury
- Infection
- Prevalence of methicillin-resistant Staphylococcus aureus in Iranian children: a systematic review and meta-analysis
- Farhad Sarrafzadeh, Seyed Mojtaba Sohrevardi, Hamid Abousaidi, Hossein Mirzaei
- Clin Exp Pediatr. 2021;64(8):415-421. Published online November 20, 2020
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The pooled prevalence of methicillin-resistant Staphylococcus aureus (MRSA) was 42% among culture-positive cases of S. aureus, 51% in hospitalized children, and 14% in healthy children. The high prevalence of MRSA in Iranian children may be due to insufficient infection control measures in hospitals, inappropriate use of methicillin, inadequate staff training, and over-prescription of antibiotics in Iran.
- Allergy
- Influence of age at complementary food introduction on the development of asthma and atopic dermatitis in Korean children aged 1–3 years
- Jihyun Lee, Meeyong Shin, Bora Lee
- Clin Exp Pediatr. 2021;64(8):408-414. Published online November 1, 2020
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Question: Is age at the time of complementary food introduction associated with asthma and atopic dermatitis (AD) in early childhood?
Finding: We found no significant association between age at the time of complementary food introduction and the incidence of AD and asthma in Koreans aged 1–3 years.
Meaning: Our findings suggest that the influence of individual allergenic foods on the development of AD and asthma should be clarified.
- Editorial
- Nephrology (Genitourinary)
- Pulmonary thromboembolism: a rare but life-threatening complication of nephrotic syndrome
- Heeyeon Cho
- Clin Exp Pediatr. 2021;64(8):406-407. Published online February 4, 2021
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Pulmonary thromboembolism (PTE) is often diagnosed in children with nephrotic syndrome. Massive PTE can cause hemodynamic instability, right ventricular failure, and circulatory collapse. Extracorporeal membrane oxygenation can be used for massive PTE as a method of hemodynamic support and adjunct to surgical embolectomy.
- Review Article
- Hematology
- Thrombosis and severe acute respiratory syndrome coronavirus 2 vaccines: vaccine-induced immune thrombotic thrombocytopenia
- Young Shil Park
- Clin Exp Pediatr. 2021;64(8):400-405. Published online June 30, 2021
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· Thrombosis and thrombocytopenia occurring within 4–28 days after severe acute respiratory syndrome coronavirus 2 vaccination require attention.
· The terms vaccine-induced immune thrombotic thrombocytopenia (VITT) and thrombosis with thrombocytopenia syndrome (TTS) are used.
· VITT is pathogenetically similar to heparin-induced thrombocytopenia.
· VITT/TTS could be associated with the development of platelet-activating anti-platelet factor 4 antibodies.
· For suspected VITT/TTS, early treatment decisions (intravenous immunoglobulin, non-heparin anticoagulant, and avoidance of platelet transfusions) are important.
- Allergy
- Food allergies and food-induced anaphylaxis: role of cofactors
- Meeyong shin
- Clin Exp Pediatr. 2021;64(8):393-399. Published online November 12, 2020
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Question: What are the roles of cofactors in food allergies and food-induced anaphylaxis?
Finding: Cofactors reportedly play a role in approximately 14%–30% of anaphylactic reactions. Cofactors such as exercise, infection, nonsteroidal anti-inflammatory drugs, dehydration, and alcohol can increase intestinal permeability and antigen uptake, thereby causing allergic symptoms.
Meaning: Routine assessment of the possible involvement of cofactors is essential for the management of patients with food-induced anaphylaxis.
- Neurology
- Is it really a seizure? The challenge of paroxysmal nonepileptic events in young infants
- Seung Yeon Jung, Joon Won Kang
- Clin Exp Pediatr. 2021;64(8):384-392. Published online September 18, 2020
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Paroxysmal nonepileptic events (PNE) comprise of a variety of nonepileptic behaviors and are divided into various types. A more accurate diagnosis is possible by examining the video clip provided by the caregiver. In infants, physiologic PNE accounts for the majority of the PNE. It is important to exclude epilepsy, for which blood tests, electroencephalography, and imaging tests can facilitate differential...
- Allergy
- Prevalence, comorbidities, diagnosis, and treatment of nonallergic rhinitis: real-world comparison with allergic rhinitis
- Hye Yung Yum, Eun Kyo Ha, Yoon Ho Shin, Man Yong Han
- Clin Exp Pediatr. 2021;64(8):373-383. Published online August 10, 2020
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Rhinitis is among the most common respiratory diseases in children. Nonallergic rhinitis, which involves nasal symptoms without evidence of systemic allergic inflammation or infection, is a heterogeneous entity with diverse manifestations and intensities. Nonallergic rhinitis accounts for 16%–89% of the chronic rhinitis cases, affecting 1%–50% (median 10%) of the total pediatric population. The clinical course of nonallergic rhinitis is generally...
- Letter to the Editor
- General Pediatrics
- Hyperinflammatory syndrome in children during the coronavirus disease 2019 pandemic in sub-Himalayan region
- Seema Sharma, Shikha Verma, Isha Bhatia, Ravinder Singh, Mohit Bajaj, Milap Sharma
- Clin Exp Pediatr. 2021;64(7):370-372. Published online May 11, 2021
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Question: Is there an increase in patients with hyperinflammatory syndrome during the coronavirus disease 2019 pandemic?
Finding: We found 10 patients with hyperinflammatory syndrome with poor outcome during a period of 2 months in a single tertiary care centre.
Meaning: Pediatricians who come across patients with muco cutaneous manifestations and multiorgan involvement should consider hyperinflammatory syndrome. Early recognition and prompt treatment of such patients may result in promising outcome.
- Original Article
- Emergency Medicine
- Comparison of clinical features and laboratory findings of coronavirus disease 2019 and influenza A and B infections in children: a single-center study
- Meraj Siddiqui, Ayşe Gültekingil, Oğuz Bakırcı, Nihal Uslu, Esra Baskın
- Clin Exp Pediatr. 2021;64(7):364-369. Published online May 18, 2021
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Question: What are the differences between coronavirus disease 2019 (COVID-19) and influenza infections in children?
Finding: Pediatric COVID-19 patients predominantly exhibited respiratory and/or gastrointestinal symptoms, neurological manifestations, olfactory/gustatory dysfunction, elevated monocytes, mildly elevated C-reactive protein, and unilateral or diffuse abnormalities on chest x-ray. Patients with underlying medical conditions had higher intensive care unit admission rates and should be followed closely.
Meaning: The clinical presentations of pediatric COVID-19 patients varied from asymptomatic/mild to severe.
- Nephrology (Genitourinary)
- Expression profiling of cultured podocytes exposed to nephrotic plasma reveals intrinsic molecular signatures of nephrotic syndrome
- Stuti Panigrahi, Varsha Chhotusing Pardeshi, Karthikeyan Chandrasekaran, Karthik Neelakandan, Hari PS, Anil Vasudevan
- Clin Exp Pediatr. 2021;64(7):355-363. Published online November 1, 2020
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Question: Is it possible to classify nephrotic syndrome (NS) through gene expression profiling of podocytes exposed to NS plasma?
Finding: Our data showed different expression profiles in podocytes exposed to nephrotic plasma from different clinical groups, suggesting the molecular stratification of patients into intrinsic subtypes.
Meaning: Transcriptome profiling of podocytes treated with NS plasma can stratify patients into intrinsic subtypes and provide insight into the molecular mechanisms of podocyte injury.
- Urinary neutrophil gelatinase-associated lipocalin: a marker of urinary tract infection among febrile children
- Ji Hyun Moon, Kee Hwan Yoo, Hyung Eun Yim
- Clin Exp Pediatr. 2021;64(7):347-354. Published online October 17, 2020
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Question: Reliably diagnosing urinary tract infection (UTI) in febrile children is often difficult. Can urinary neutrophil gelatinase-associated lipocalin (uNGAL) better predict UTI and acute pyelonephritis (APN) than serum C-reactive protein (CRP) and white blood cell (WBC) count?
Finding: uNGAL better facilitated the prediction of UTI and APN, than serum CRP and WBC counts in febrile children.
Meaning: uNGAL is a suitable biomarker for UTI and APN in febrile children.
- Developmental and Behavioral Medicine
- Is meconium exposure associated with autism spectrum disorders in children?
- Ensiyeh Jenabi, Erfan Ayubi, Salman Khazaei, Saeid Bashirian, Mojtaba Khazaei
- Clin Exp Pediatr. 2021;64(7):341-346. Published online October 4, 2020
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• Meconium exposure is weakly associated with an increased risk of autism spectrum disorder (ASD) development in children.
• More evidence based on large prospective cohort studies is required to conclude whether meconium exposure is associated with an increased risk of ASD.
- Editorial
- Neurology
- Recent trends in autism spectrum disorder research using text mining of PubMed: importance of early detection
- Seung Soo Kim
- Clin Exp Pediatr. 2021;64(7):339-340. Published online November 9, 2020
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Behavioral therapy, the most widely proven intervention for the core symptoms of autism spectrum disorder (ASD), is required for life for individuals with ASD. Parent involvement, early detection, and early therapy play important roles. We must organize the risk factors for ASD and develop a screening tool that can be easily applied in the clinical, daycare, or school setting.
- Review Article
- Infection
- Updates on the coronavirus disease 2019 vaccine and consideration in children
- Hyun Mi Kang, Eun Hwa Choi, Yae-Jean Kim
- Clin Exp Pediatr. 2021;64(7):328-338. Published online June 21, 2021
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· The number of coronavirus disease 2019 cases has exponentially increased worldwide, and children ≤19 years old account for 11.0% of all confirmed cases.
· mRNA vaccines, BNT162b2 and mRNA-1273, and adenoviral vector vaccines, AZD1222 and Ad26.COV2.S, authorized for emergency use in the Emergency Use Listing of the World Health Organization are reviewed.
· Clinical trials of these vaccines have shown that they are safe and serious adverse reactions are rarely observed.
- School closures during the coronavirus disease 2019 outbreak
- Eun Young Cho, Young June Choe
- Clin Exp Pediatr. 2021;64(7):322-327. Published online May 31, 2021
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· Earlier modeling studies of the effects of school closures on severe acute respiratory syndrome coronavirus 2 were largely derived from the pandemic influenza model, resulting in conflicting implications.
· Observational findings suggest no clear effect of school closures on community transmission or overall mortality.
· School closures must be weighed against potential high social costs, which can also negatively affect children’s health.
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