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Letter to the Editor
Pulmonology
Metabolic syndrome and pulmonary dysfunction in asthmatic children during the COVID-19 pandemic
Jue Seong Lee, Sang Hyun Park, Yoon Lee, Seunghyun Kim, Wonsuck Yoon, Young Yoo
Clin Exp Pediatr. 2024;67(3):168-170.   Published online February 19, 2024
Review Article
Allergy
Practical issues of oral immunotherapy for egg or milk allergy
Sukyung Kim, Kangmo Ahn, Jihyun Kim
Clin Exp Pediatr. 2024;67(3):140-148.   Published online June 19, 2023
· Oral immunotherapy should be supervised by pediatricians with experience administering oral food challenge tests and managing allergic reactions.
· Food allergen intake is gradually increased and maintained for years.
· Patients may experience allergic reactions and psychological problems.
· Adjunctive therapies (biologics, antihistamines, and leukotriene receptor antagonists) may improve efficacy and safety.
· Contraindications include uncontrolled asthma, malignancy, active autoimmune disorders, and beta-blocker usage.
Other
Acetaminophen causes neurodevelopmental injury in susceptible babies and children: no valid rationale for controversy
Lisa Zhao, John P. Jones, Lauren G. Anderson, Zacharoula Konsoula, Cynthia D. Nevison, Kathryn J. Reissner, William Parker
Clin Exp Pediatr. 2024;67(3):126-139.   Published online June 14, 2023
Despite worldwide acceptance of acetaminophen (paracetamol) in pediatric medicine, careful examination reveals no valid objections to the conclusion that early exposure to acetaminophen causes neurodevelopmental injury in susceptible babies and children. Nevertheless, debate that early exposure to acetaminophen causes neurodevelopmental injury has centered around the prenatal period, evidence of which is relatively limited compared to that in the postnatal period, which is the time of greatest absolute and relative risk.
MicroRNAs as novel biomarkers for the diagnosis and treatment of pediatric diseases
Hwal Rim Jeong, Il Tae Hwang
Clin Exp Pediatr. 2024;67(3):119-125.   Published online May 24, 2023
MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression post transcriptionally, and MiRNA expression levels vary with developmental stages. MiRNAs play an important role in several biological processes in children, including growth, neuro-development, inflammation, and tumor formation. Research on miRNAs may uncover the molecular mechanisms underlying various pediatric diseases, leading to the development of novel biomarkers that aid in the diagnosis, treatment, and prognosis of these diseases.
Original Article
Other
Virtual, augmented, and mixed reality: potential clinical and training applications in pediatrics
Suyoung Yoo, Meong Hi Son
Clin Exp Pediatr. 2024;67(2):92-103.   Published online May 24, 2023
· Review of articles that investigated the applications of virtual, augmented, or mixed reality in pediatric clinical settings and in the training of pediatric medical professionals was conducted.
· A total of 89 studies were retrieved, with 36 randomized controlled trials.
· In most studies, intervention using the novel technology was at least as effective or more effective than the traditional method.
· Use of virtual, augmented, and mixed reality has potential in pediatrics.
Clinical Note
Neurology
Expanding association between BICD2 variants and brain malformations and associated lissencephaly
Jaeso Cho, Haeryung Kim, Seoungbok Lee, Jihoon G Yoon, HyeJin Kim, Minhye Kim, Seoyun Jang, Woojoong Kim, Soo Yeon Kim, Jong Hee Chae
Clin Exp Pediatr. 2024;67(1):54-56.   Published online December 21, 2023
Review Article
Nephrology (Genitourinary)
X-linked hypophosphatemic rickets: from diagnosis to management
Eujin Park, Hee Gyung Kang
Clin Exp Pediatr. 2024;67(1):17-25.   Published online June 14, 2023
· X-linked hypophosphatemia (XLH), the most common cause of hypophosphatemic rickets, affects 1/20,000 people.
· XLH is caused by a loss-of-function mutation of the PHEX gene.
· Its main pathogenesis is elevated fibroblast growth factor-23 (FGF23) level.
· Burosumab, an FGF23 inhibitor, was developed in the early 2000s.
· Burosumab was approved in Korea in 2020 for XLH patients aged 1+ years with radiographic evidence of bone disease.
Original Article
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
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.
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
· 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.
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
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
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.
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
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.
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
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.
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
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.
Review Article
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
· 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.
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
Review Article
Allergy
Recent topics on gastrointestinal allergic disorders
Yoshiyuki Yamada
Clin Exp Pediatr. 2023;66(6):240-249.   Published online January 9, 2023
Gastrointestinal (GI) allergies are divided into immunoglobulin E (IgE)-mediated, non-IgE-mediated, and mixed types. In addition to non-IgE-mediated, overlapping eosinophilic GI disorders (EGIDs) have increased in Japan. EGIDs, a mixed-type allergy category, include eosinophilic esophagitis (EoE) and non-EoE EGIDs. The number of EoE cases has increased in Western countries, followed by Asian countries. Recent GI allergies may also be associated with type 2 inflammation.
Editorial
Infection
Impact and role of vitamins as immunonutrition in children during COVID-19 pandemic
Yoo Min Lee
Clin Exp Pediatr. 2023;66(5):212-214.   Published online April 18, 2023
· Vitamins have effector mechanisms in the innate and adaptive immune systems and potential roles in preventing and reducing the severity of coronavirus disease 2019 (COVID-19).
· Vitamins may be immunonutrients in the treatment of COVID-19 infections and prevention of patient deterioration due to critical illness, thus demonstrating the significance of a nutritious, well-balanced diet.
Review Article
Neurology
Electroencephalography source localization
Tae-Hoon Eom
Clin Exp Pediatr. 2023;66(5):201-209.   Published online December 29, 2022
· Electroencephalography (EEG) directly images the electrical activity of neurons at a higher temporal resolution than other neuroimaging techniques.
· EEG is still widely used in brain function research due to its advantages.
· Forward and inverse problems of EEG analyses require solutions.
· Methods such as the dipole and distributed source models have been introduced.
· Applications of EEG are expanding with the integration of other technologies and large-scale data.
Original Article
Infection
Predicting COVID-19 transmission in a student population in Seoul, South Korea, 2020–2021
Young Hwa Lee, Han Ho Kim, Young June Choe
Clin Exp Pediatr. 2023;66(4):173-178.   Published online December 22, 2022
Question: What is the spatial distribution and determinants of coronavirus disease 2019 (COVID-19) infection among students in Korea?
Finding: The community population was closely associated with the risk of COVID-19, and the number of students per school class were inversely associated with COVID-19 rates in students.
Meaning: Our finding suggests that controlling the community-level burden of COVID-19 can help prevent sudden acute respiratory syndrome coronavirus 2 infection in school-aged children.
Review Article
Allergy
New approaches to immunotherapy in house dust mite allergy
In Sik Kim
Clin Exp Pediatr. 2023;66(4):161-168.   Published online October 25, 2022
Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. Moreover, clinical trials have proved their significantly therapeutic effects in allergy. This article review focuses on HDM allergens developed for AIT efficacy,...
Nutrition
Association of gut microbiota with obesity in children and adolescents
Ky Young Cho
Clin Exp Pediatr. 2023;66(4):148-154.   Published online November 16, 2022
The gut microbiota is an emerging factor in the development of pediatric obesity, which is affected by renowned risk factors such as diet, lifestyle, and socioeconomic status. This review aimed to describe the association between the gut microbiota and childhood obesity.
Clinical Note
Genetics and Metabolism
Biallelic POLR3A variants cause Wiedemann-Rautenstrauch syndrome with atypical brain involvement
Byungseung Moon, Minhye Kim, Hye Jin Kim, Jae So Cho, Hey Joon Son, Byung Chan Lim, Ki Joong Kim, Jong Hee Chae, Soo Yeon Kim
Clin Exp Pediatr. 2023;66(3):142-144.   Published online December 30, 2022
Original Article
Infection
Clinical characteristics of pediatric patients infected with SARS-CoV-2 versus common human coronaviruses: a national multicenter study
In Suk Sol, Eun Lee, Hyeon-Jong Yang, Yong Ju Lee, Hye Yung Yum, Mi-Hee Lee, Mi Ae Chu, Hui Jeong Moon, Hyo-Bin Kim, Ju Hee Seo, Jung Yeon Shim, Ji Young Ahn, Yoon Young Jang, Hai Lee Chung, Eun Hee Chung, Kyunghoon Kim, Bong-Seong Kim, Cheol Hong Kim, Yang Park, Meeyong Shin, Kyung Suk Lee, Man Yong Han, Soo-Jong Hong, Eun Kyeong Kang, Chang Keun Kim; on behalf of The Pneumonia & Respiratory Disease Study Group of Korean Academy of Pediatric Allergy and Respiratory Disease
Clin Exp Pediatr. 2023;66(3):134-141.   Published online December 22, 2022
Question: The clinical differences between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and human coronaviruses (HCoV) in children remain unknown.
Finding: This study compared the clinical findings of children infected with SARS-CoV-2 versus HCoV. Its findings suggest that children and adolescents with SARS-CoV-2 have a milder clinical course than those with HCoV.
Meaning: The clinical course of children and adolescents with SARS-CoV-2 should be closely monitored during the coronavirus disease 2019 pandemic.
Clinical Note
Rheumatology
Haploinsufficiency A20 misdiagnosed as PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome with Kikuchi disease
Kyo Jin Jo, Su Eun Park, Chong Kun Cheon, Seung Hwan Oh, Seong Heon Kim
Clin Exp Pediatr. 2023;66(2):82-84.   Published online June 22, 2022
Original Article
Neurobehavior
Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis
Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei
Clin Exp Pediatr. 2023;66(2):70-75.   Published online August 17, 2022
Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I2=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.
Neonatology (Perinatology)
A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants
Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun
Clin Exp Pediatr. 2023;66(1):32-37.   Published online December 15, 2022
Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.
Nutrition
Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis
Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Salman Khazaei
Clin Exp Pediatr. 2023;66(1):28-31.   Published online July 19, 2022
This study aimed to determine whether there is an association between not breastfeeding (versus breastfeeding) and the risk of autism spectrum disorders (ASD) among children. We found that the risk of ASD associated with not breastfeeding had an odds ratio of 1.81 (95% confidence interval, 1.35–2.27; I2=0 %). These findings suggest the importance of breastfeeding in decreasing the risk of ASD among children.
Pulmonology
Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress
Kantara Saelim, Busawan Thirapaleka, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree
Clin Exp Pediatr. 2022;65(12):595-601.   Published online November 1, 2022
SpO2/FiO2 ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients.
Gastroenterology
Ability of polymicrobial probiotic and mono-strain probiotic to reduce functional abdominal pain in children: a randomized clinical trial
Seyed Sajad Jafari, Seyed Mojtaba Hashemi, Bahman Sadeghi, Amir Almasi-Hashiani
Clin Exp Pediatr. 2022;65(12):589-594.   Published online October 31, 2022
· This study compared the ability of 2 probiotics to reduce and improve functional abdominal pain (FAP) in children.
· In the polymicrobial probiotic (PMP) group, 10.34% of children reported no pain; in the mono-strain probiotic (MSP) group, all patients reported low-degree pain. The mean pain score decreased significantly over time in both groups.
· The use of both PMP and MSP is recommended to reduce pain in patients with FAP.
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