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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
Psychiatric/Psychology
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.
Original Article
Neonatology (Perinatology)
Evaluation of the role of ischemia modified albumin in neonatal hypoxic-ischemic encephalopathy
Mohamed A. Talat, Rabab M. Saleh, Mohammed M. Shehab, Naglaa A. Khalifa, Maha Mahmoud Hamed Sakr, Walaa M. Elmesalamy
Clin Exp Pediatr. 2020;63(8):329-334.   Published online August 15, 2020
Question: What is the value of ischemia modified albumin (IMA) as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE)?
Finding: IMA levels were significantly higher (nearly double elevation) in hypoxic than healthy newborns in the first few hours after birth in the full-term neonates.
Meaning: IMA can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity.
Cardiology
Age-, sex-, and height-based blood pressure reference charts, Yazd children 6–18 years, Iran
Nastaran ahmadi, Seyedeh Mahdieh Namayandeh, Seyed Mahmood Sadr Bafghi, Mohammad Reza Mohammadi, Masoud Mirzaei, Mohammadtaghi Sarebanhassanabadi, Amir Houshang Mehrparvar, Reza Faraji, Neda Nilforoshan, Ahmad Karimi
Clin Exp Pediatr. 2020;63(8):321-328.   Published online July 21, 2020
Question: What is the 90th, 95th, 99th percentile of blood pressure based on height as the cut point for diagnosis of hypertension in children of our province?
Finding: We used blood pressure of 456 males and 579 females in 6–18 years old in “Iranian Children and Adolescents' Psychiatric Disorders survey.
Meaning: The 90th, 95th, 99th percentiles of systolic and diastolic blood pressure in both sex based on age and 10-cm height intervals were developed in Yazd.
Hematology
Effects of α-tocopherol on hemolysis and oxidative stress markers on red blood cells in β-thalassemia major
Nora Sovira, Munar Lubis, Pustika Amalia Wahidiyat, Franciscus D. Suyatna, Djajadiman Gatot, Saptawati Bardosono, Mohammad Sadikin
Clin Exp Pediatr. 2020;63(8):314-320.   Published online August 15, 2020
Question: Is the α-tocopherol as an exogenous antioxidant supplementation effective in improving hemolysis and oxidative stress on β-thalassemia major?
Finding: We found significant enhancements in plasma haptoglobin were noted in the α-tocopherol group (3.01 mg/dL; range, 0.60–42.42 mg/dL; P=0.021).
Meaning: The α-tocopherol can improve hemolysis by increasing the haptoglobin level as hemolysis marker.
Review Article
Nutrition
Components of human breast milk: from macronutrient to microbiome and microRNA
Su Yeong Kim, Dae Yong Yi
Clin Exp Pediatr. 2020;63(8):301-309.   Published online March 23, 2020
Human breast milk (HBM) is essential for the infant’s growth and development right after birth and is an irreplaceable source of nutrition for early human survival. Various infant formulas have many similarities to HBM in many components, but there is no perfect substitute for HBM. Recently, various breast milk components and their roles have been studied according to the development...
Neurology
Autoimmune encephalitis and epilepsy: evolving definition and clinical spectrum
Joo Hee Seo, Yun-Jin Lee, Ki Hyeong Lee, Elakkat Gireesh, Holly Skinner, Michael Westerveld
Clin Exp Pediatr. 2020;63(8):291-300.   Published online August 16, 2019
Advances in autoimmune encephalitis studies in the past 10 years have led to the identification of new syndromes and biomarkers that have transformed the diagnostic approach to the disorder. The disorder or syndrome has been linked to a wide variety of pathologic processes associated with the neuron-specific autoantibodies targeting intracellular and plasma membrane antigens. However, current criteria for autoimmune encephalitis...
Neonatology (Perinatology)
Short- and long-term outcomes of very low birth weight infants in Korea: Korean Neonatal Network update in 2019
Jang Hoon Lee, YoungAh Youn, Yun Sil Chang; Korean Neonatal Network
Clin Exp Pediatr. 2020;63(8):284-290.   Published online February 5, 2020
The Korean Neonatal Network (KNN) has collected population-based data for very low birth weight infants (VLBWIs) born in Korea since 2013. The survival rate of all VLBWIs was 86% in Korea. The overall prevalence of cerebral palsy was 6.2%–6.6%. Bilateral blindness and hearing loss were reported in 0.2%–0.3%, 0.8%–1.9%, respectively. The KNN has published annual reports and papers for facilitating the improvement of VLBWIs outcome in Korea.
Original Article
Allergy
Ten-year trends and prevalence of asthma, allergic rhinitis, and atopic dermatitis among the Korean population, 2008–2017
Jihyun Ha, Seung Won Lee, Dong Keon Yon
Clin Exp Pediatr. 2020;63(7):278-283.   Published online January 29, 2020
Background: Major questions remain regarding the agestratified trends of allergic diseases and asthma in Korea.
Purpose: To identify the estimated recent prevalence and 10- year trends in asthma, allergic rhinitis, and atopic dermatitis among the Korean population from 2008 to 2017. Methods: This nationwide cross-sectional survey (Korean National Health and Nutrition Examination Survey) over 10 years (2008–2017) examined representative samples of the...
General Pediatrics
Efficacy of conservative treatment of perianal abscesses in children and predictors for therapeutic failure
Lars Boenicke, Johannes Doerner, Stefan Wirth, Hubert Zirngibl, Mike Ralf Langenbach
Clin Exp Pediatr. 2020;63(7):272-277.   Published online May 15, 2020
Background: The optimal management of perianal abscess in children is controversial.
Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001–2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary...
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