Most cited

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Most-cited articles are from the articles published during the last two years (2024 ~ ).

Review Article
Infection
Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review
Mohamad Shieb, Rand Hasanain, Zara Arshad, Faisal A. Nawaz, Rahul Kashyap, Eric J. Stern
Clin Exp Pediatr. 2024;67(9):427-434.   Published online April 5, 2024
The overall incidence of bloodstream infections was 23.5%. Gram-negative organisms occur at a much higher rate in pediatric liver transplant recipients then that the general pediatric population. However, when comparing pediatric and adult liver transplant recipients Gram-positive organisms occur with a much higher rate in the pediatric population highlighting the importance of early and broad spectrum antimicrobial coverage when bloodstream infections are suspected.
Letter to the Editor
Developmental and Behavioral Medicine
Efficacy of social skills group intervention among children with mild autism spectrum disorder
Lee Ling Low, Ker Yang Chua, Bih Hwa Ching
Clin Exp Pediatr. 2024;67(7):368-370.   Published online May 31, 2024
Original Article
Nutrition
Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach
Ratu Ayu Dewi Sartika, Fadila Wirawan, Wawan Gunawan, Primasti Nuryandari Putri, Nurul Husna Mohd Shukri
Clin Exp Pediatr. 2024;67(7):358-367.   Published online June 21, 2024
Question: Does paternal support affect exclusive breastfeeding failure?
Finding: Exclusive breastfeeding failure by 3 months was affected by paternal support.
Meaning: Fathers should be included in breastfeeding education and antenatal care.
Developmental and Behavioral Medicine
Effectiveness of online responsive teaching in young children with developmental disabilities: a pilot study
Jung Sook Yeom, Jeongmee Kim
Clin Exp Pediatr. 2024;67(6):303-311.   Published online May 21, 2024
Question: Does online responsive teaching (RT) impact children's and parents’ emotions and behaviors, and do parents find it satisfactory?
Finding: Online RT significantly improved children's pivotal and problem behaviors, decreased parenting stress, and enhanced parental interactive styles with high satisfaction.
Meaning: This pilot study's findings suggest that online RT can enhance child outcomes, offering accessible interventions amid challenges such as limited access and pandemics.
Letter to the Editor
Neonatology (Perinatology)
Pentraxin 3 as a marker of early-onset neonatal sepsis
Safaa ELMeneza, Iman El-Bagoury, Hind Rayes, Amira Hassan
Clin Exp Pediatr. 2024;67(6):312-314.   Published online May 23, 2024
Review Article
Other
Children’s health affected by parent’s behavioral characteristics: a review
Sung Eun Kim, Jongin Lee
Clin Exp Pediatr. 2024;67(5):232-239.   Published online August 21, 2023
· Parents’ occupational hazards, long working hours, and smoking behaviors should be modified adequately to minimize adverse health effects on their children.
· As of 2023, several diseases from fetal exposure to occupational hazards can be compensated with Industrial Accident Compensation Insurance in South Korea.
· A directed acyclic graph is recommended for medical research to control the effects of parents’ behaviors on children’s health.
Adolescence Medicine
Diet-related behaviors affecting health and substance use among children and adolescents
Ji-Hyun Seo, Sochung Chung
Clin Exp Pediatr. 2024;67(12):664-671.   Published online October 31, 2024
· Diet behaviors in children and adolescents are influenced by environmental and sociocultural factors.
· Unhealthy diet behaviors and poor diet quality are the main contributing factors to noncommunicable diseases and mental health problems during childhood and adolescence.
· Smoking and alcohol drinking in children and adolescents may be associated with unhealthy diet behavior or poor diet quality.
Original Article
Other
Balance assessment with decreased base of support for children with disabilities
Guilherme M. Cesar, Madison Giebler, Thad W. Buster, Judith M. Burnfield
Clin Exp Pediatr. 2024;67(12):718-724.   Published online November 11, 2024
Question: Can a balance task with narrowed base of support indicate overall functional balance control in children with disabilities?
Finding: While single-limb standing could explain overall balance control for children with disabilities, it was unrelated with balance control for typically developing children.
Meaning: One balance task with narrowed base of support can be used as practical assessment of balance abilities for children with disabilities when allocated session time is of concern.
Infection
Clinical, biochemical, and genetic study of TACE/TNF-α/ACE signaling pathway in pediatric COVID-19 infection
Ahmed El-Abd Ahmed, Sawsan M.A. Abuhamdah, Mohammed H. Hassan, Nagwan I. Rashwan, Eman A. Abd-Elmawgood, Haggagy Mansour, Hoda S. Sherkawy, Shymaa G. Rizk
Clin Exp Pediatr. 2024;67(12):704-717.   Published online November 27, 2024
Question: Is the tumor necrosis factor (TNF) signaling pathway (TNF-α-converting enzyme [TACE]/TNF-α/angiotensin converting enzyme [ACE]) involved in pediatric coronavirus disease 2019 (COVID-19) infection?
Finding: Significantly increased circulating TACE/TNF-α and decreased ACE2 levels were noted. TNF-α-308G/A plays a significant role in susceptibility to COVID-19 infection among children. The ACE (I/D) (rs4646994) and ACE2 (rs2285666) single nucleotide polymorphisms lack significant associations with pediatric COVID-19 infection.
Meaning: The TNF signaling pathway participates in pediatric COVID-19 infection.
Clinical Note
Nephrology (Genitourinary)
B4GALT1-related congenital disorder of glycosylation mimicking Ehlers-Danlos syndrome: a child with multisystem involvement and nephrotic syndrome
Marifat Ganieva, Muqaddas Boltaboeva, Umida Ganiyeva, Oksana Efimenko, Abdulhamid Haydarov, Sherzod Toshboev
Clin Exp Pediatr. 2026;69(9):748-750.   Published online July 20, 2026
Original Article
Endocrinology
Rising incidence of central precocious puberty in Thailand: a nationwide population-based study before, during, and after the COVID-19 pandemic (2018–2024)
Pattara Wiromrat, Preamrudee Poomthavorn, Ratikorn Chaisiwamongkol, Chaiyawat Suppasilp, Ouyporn Panamonta, Ratchaneewan Sinitkul
Clin Exp Pediatr. 2026;69(9):733-742.   Published online August 19, 2026
Question: Did the incidence of central precocious puberty (CPP) and premature thelarche (PT) among Thai children change during 2018–2024?
Finding: CPP incidence in girls more than doubled during the COVID-19 pandemic and remained elevated thereafter, primarily at age 8 to <9 years. PT incidence increased progressively, particularly in girls aged 7 to <8 years.
Meaning: In peripubertal age groups, CPP and PT incidence increases may reflect pandemic-related factors, obesity, awareness, or earlier pubertal onset.
Thyroid peroxidase gene variants and susceptibility to congenital hypothyroidism and autoimmune thyroid disease among Egyptian pediatric cohort
Hala M. Sakhr, Mohammed H. Hassan, Esraa Abbass Abdallah, Amira Mahmoud Ewis, Mohamed Hesham Mohamed, Shymaa Gaber Rizk
Clin Exp Pediatr. 2026;69(6):486-496.   Published online March 26, 2026
Question: Which factors influence pediatric thyroid disorder susceptibility and severity?
Finding: Anemia, selenium deficiency, excess copper, and the thyroid peroxidase (TPO) Arg386His polymorphism, especially with the histidine/histidine genotype, are strongly associated with pediatric thyroid disease and high thyroid-stimulating hormone levels.
Meaning: Pediatric thyroid disorders are multifactorial. The TPO Arg386His variant may help identify children at higher risk of severe thyroid dysfunction, enabling earlier diagnosis, improved risk stratification, and more personalized clinical management.
Review Article
Allergy
Update on pediatric allergic rhinitis: narrative review based on guideline updates
Jung Yeon Shim
Clin Exp Pediatr. 2026;69(6):473-483.   Published online May 28, 2026
Intranasal corticosteroids remain the cornerstone treatment for moderate to severe allergic rhinitis. The 2024–2025 Allergic Rhinitis and its Impact on Asthma guideline update suggests that fixed intranasal antihistamine–intranasal corticosteroid combinations may provide greater symptom control in allergic rhinitis than either agent alone. A control-based patient-centered approach that incorporates real-world evidence is essential for optimizing treatment outcomes in children.
Original Article
Neurology
Classification of neurocognitive impairment in pediatric drug-resistant focal epilepsy by quantifying seizure-affected brain network abnormalities in clinical diffusion-weighted imaging connectome
Jeong-Won Jeong, Min-Hee Lee, Yoon Ho Hwang, Michael Behen, Aimee Luat, Csaba Juhász, Eishi Asano
Clin Exp Pediatr. 2026;69(5):443-454.   Published online March 13, 2026
Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy?
Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients.
Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects.
Cardiology
Influence of atrial septal defect on mitral valve growth after repair of coarctation of the aorta or an interrupted aortic arch in infants
Yi-Chia Wang, Heng-Wen Chou, Chi-Hsiang Huang, Hsing-Hao Huang, Yih-Sharng Chen, En-Ting Wu, Shyh-Jye Chen, Ming-Tai Lin, Shuenn-Nan Chiu, Shu-Chien Huang
Clin Exp Pediatr. 2026;69(4):322-329.   Published online January 13, 2026
Question: Does atrial septal defect (ASD) physiology affect postrepair mitral valve growth in patients with coarctation of the aorta or an interrupted aortic arch?
Finding: Mitral valve growth occurred after biventricular repair but not single-ventricle palliation, particularly in patients with small valves and low ASD pressure gradients.
Meaning: The ASD pressure gradient determines mitral valve growth and should guide surgical strategies in patients with borderline hypoplastic left heart syndrome.
Neonatology (Perinatology)
Hemodynamics and cerebral oxygenation in the neonatal transition: a prospective pilot study
Daniel Pfurtscheller, Christoph Schlatzer, Nina Höller, Bernhard Schwaberger, Lukas P. Mileder, Nariae Baik-Schneditz, Magdalena Holter, Gerhard Pichler
Clin Exp Pediatr. 2026;69(4):330-339.   Published online January 13, 2026
Question: How is arterial blood pressure related to cerebral oxygenation during the immediate postnatal transition in neonates?
Finding: Among preterm infants requiring respiratory support, cerebral oxygenation was associated with diastolic and mean arterial pressures, indicating passive pressure perfusion.
Meaning: Compromised preterm infants are vulnerable to impaired autoregulation with cerebral oxygenation fluctuations, highlighting the need for hemodynamic and cerebral monitoring plus routine monitoring of arterial oxygen saturation and heart rate.
Cardiology
Value of demographic factors in early identification of pediatric malignant vasovagal syncope in head-up tilt test
Shuo Wang, Yuwen Wang, Hong Cai, Ping Liu, Fang Li, Chuan Wen, Liqun Liu, Runmei Zou, Cheng Wang
Clin Exp Pediatr. 2026;69(4):353-361.   Published online March 5, 2026
Question: Can demographic factors identify pediatric malignant vasovagal syncope pre-head-up tilt test (HUTT)?
Finding: Age/body mass index are independent protectors; <12.9 years age cuts risk 20%/yr.
Meaning: Enables early risk stratification to optimize HUTT safety for children.
Review Article
Neonatology (Perinatology)
Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea
In Gyu Song, Trisha M. Prentice, Lynn Gillam
Clin Exp Pediatr. 2026;69(4):282-292.   Published online March 13, 2026
Shared decision-making (SDM) offers an ethically grounded, relational approach to making difficult decisions in neonatal care. Its effective use depends on recognizing when its use is appropriate and enacted in clinical conversations. In Korea, while parents are often involved in decision-making, SDM is not yet consistently articulated or evaluated as a structured practice. Culturally grounded research, education, and institutional support are needed to strengthen family-centered neonatal care.
Original Article
Gastroenterology
Longitudinal analysis of gut microbiota dysbiosis and bacterial signatures predictive of postoperative enterocolitis in children with Hirschsprung disease
Sireekarn Chantakhow, Chanon Kunasol, Jiraporn Khorana, Kanokkan Tepmalai, Nipon Chattipakorn, Siriporn C. Chattipakorn
Clin Exp Pediatr. 2026;69(3):214-227.   Published online December 10, 2025
Question: Do gut microbiota differ between patients with Hirschsprung disease (HSCR) and healthy children, and can specific bacterial taxa predict postoperative HSCRassociated enterocolitis (HAEC)?
Finding: Patients with HSCR showed gut dysbiosis with reduced diversity. Postoperative microbial changes included increased alpha diversity. Certain taxa, such as Eubacterium and Collinsella, were associated with recovery or HAEC.
Meaning: Distinct microbial signatures may help identify HAEC risk and guide microbiota-based strategies to improve outcomes.
Neonatology (Perinatology)
Thrombocytopenia in preterm infants born to mothers with systemic lupus erythematosus: a retrospective cohort study
Ru Xue, Guoqing Zhang, Xiafang Chen, Jun Bu, Lanlan Mi, Fei Bei
Clin Exp Pediatr. 2026;69(3):266-273.   Published online December 22, 2025
Question: What are the characteristics and clinical implications of thrombocytopenia in preterm neonates born to mothers with systemic lupus erythematosus?
Finding: Nearly one-third of preterm infants developed thrombocytopenia. Key modulators of this risk included gestational age, maternal hypertensive disorders of pregnancy, and hydroxychloroquine use. Thrombocytopenia may be associated with neonatal morbidity.
Meaning: Platelet count should be monitored during the first week of life, and infants should be assessed for potential complications.
Hematology
Granulocyte transfusion improves survival in pediatric febrile neutropenia: a 15-year cohort study
Witsanu Phetsai, Kleebsabai Sanpakit, Jassada Buaboonnam, Kamon Phuakpet, Nassawee Vathana, Nattee Narkbunnam, Fon Kladed, Chayamon Takpradit
Clin Exp Pediatr. 2026;69(3):236-246.   Published online January 12, 2026
Question: Does granulocyte transfusion improve survival and clinical recovery in pediatric febrile neutropenia?
Finding: In this 15-year real-world cohort, granulocyte transfusion significantly increased 30-day survival (92.3 % vs. 65.4%; adjusted odds ratio, 0.105; P=0.020) and accelerated fever and neutrophil recovery without serious adverse events.
Meaning: Granulocyte transfusion may be an effective adjunctive therapy for severe neutropenic infections in children, particularly in low- and middle-income settings.
Neonatology (Perinatology)
Validation of a new Japanese classification for predicting severe bronchopulmonary dysplasia in preterm infants
Masato Ito, Shinya Hirano, Fumihiko Namba
Clin Exp Pediatr. 2026;69(3):274-281.   Published online January 20, 2026
Question: Can the revised Japanese classification predict severe bronchopulmonary dysplasia (BPD) early in preterm infants?
Finding: Small for gestational age and bubbly/cystic chest radiographic patterns were independently associated with severe BPD, and subtypes I and III showed particularly strong associations.
Meaning: This classification may facilitate early risk stratification and guide timely supportive strategies to prevent progression to severe BPD.
Review Article
Gastroenterology
Balancing therapeutic benefits and hidden risks of proton pump inhibitors in pediatric practice: a narrative review and update
Maria Rogalidou, Alexandra Papadopoulou
Clin Exp Pediatr. 2026;69(3):186-196.   Published online February 25, 2026
Proton pump inhibitors (PPIs) effectively treat acid-related disorders, including gastroesophageal reflux disease, eosinophilic esophagitis, peptic ulcers, and Zollinger-Ellison syndrome. Long-term use, particularly in children, may lead to microbiome alterations, nutrient deficiencies, infections, renal injury, osteoporosis, fractures, and other gastrointestinal changes. PPI therapy should be guided by clear clinical indications, prescribed at the lowest effective dose for the shortest necessary duration, and regularly reassessed to minimize risks in young children.
Editorial
Neonatology (Perinatology)
Early prediction of bronchopulmonary dysplasia using new classification in high-risk preterm infants
Ga Won Jeon
Clin Exp Pediatr. 2026;69(3):211-213.   Published online February 25, 2026
The definition of bronchopulmonary dysplasia (BPD) has continued to evolve. Recently, newer definitions based on respiratory support at 36 weeks’ postmenstrual age better predict long-term outcomes but diagnose BPD relatively late. To address this limitation, the New Japanese Classification uses early postnatal factors, including small for gestational age and bubbly or cystic chest radiographic findings, to predict severe BPD and enable early targeted interventions.
Correspondence
Endocrinology
A commentary on “Testosterone therapy in boys with constitutional delay of growth and puberty: a PubMed-based systematic review and exploratory meta-analysis”
Muqaddas Boltaboeva, Abdulhamid Haydarov, Lola Rakhmanova
Clin Exp Pediatr. 2026;69(10):820-822.   Published online September 17, 2026
Current evidence suggests that testosterone therapy is effective in boys with constitutional delay of growth and puberty; however, important knowledge gaps persist regarding genetic predisposition, nutritional and clinical factors, baseline endocrine assessments, and long-term outcomes. Addressing these factors may improve patient selection, optimize treatment strategies, and facilitate more individualized clinical decision-making.
Original Article
Neonatology (Perinatology)
Maternal metformin protects developing auditory brainstem function after neonatal hypoxia-ischemia in a neonatal rat model
Sei Eun Kim, Joo Young Kweon, Yong Joo Ahn, Jun Hee Kim
Clin Exp Pediatr. 2026;69(10):806-816.   Published online September 17, 2026
Question: Does maternal metformin administration during pregnancy protect offspring auditory brainstem function after neonatal hypoxia-ischemia (HI)?
Finding: Maternal metformin prevented HI-induced hearing threshold elevation, preserved auditory brainstem response amplitudes, and partially rescued neuronal and oligodendrocyte lineage cells in the medial nucleus of the trapezoid body.
Meaning: Maternal metformin during gestation may serve as a prenatal neuroprotective strategy against neonatal hypoxic-ischemic brain injury.
Rheumatology
Recurrent immunoglobulin A vasculitis in children and adolescents: prevalence and associated risk factors
Nootsara Atchariyaphuk, Maynart Sukharomana, Thanaporn Chaiyapak, Sirirat Charuvanij
Clin Exp Pediatr. 2026;69(1):46-55.   Published online October 22, 2025
Question: What can predict immunoglobulin A vasculitis (IgAV) recurrence, and when does it occur? How do childhood- and adolescent-onset IgAV compare?
Finding: The IgAV recurrence rate was 35.6%. It usually occurred within 12 months and was associated with corticosteroids treatment.
Meaning: Childhood-onset IgAV more commonly featured gastrointestinal and musculoskeletal manifestations and required hospitalization. Adolescent-onset IgAV more commonly featured renal involvement. Vigilant monitoring for recurrence is necessary, particularly with corticosteroids treatment.
Clinical Note
Neonatology (Perinatology)
External tracheal compression and mucosal injury in a neonate with cervical teratoma: a rare airway challenge
Rhodora Guillen, Arijit Lodha, Prashanth Murthy
Clin Exp Pediatr. 2026;69(1):73-75.   Published online December 4, 2025
Review Article
Endocrinology
Pubertal induction in prepubertal males with hypogonadotropic hypogonadism: testosterone or gonadotropins?
Paolo Cavarzere, Riccardo Battiston, Valentina Lupieri, Valentina Mancioppi, Claudio Maffeis
Clin Exp Pediatr. 2026;69(1):1-10.   Published online December 18, 2025
The pubertal induction process in males still poses a challenge for pediatric endocrinologists. The existing literature is limited, and it is not yet possible to make definitive recommendations. We described the various treatment for this condition and tried to analyze the unresolved questions to address the question posed in the title of our manuscript.
Original Article
Pulmonology
Effect of vitamin C supplement in treatment of childhood pneumonia requiring hospitalization: a randomized controlled trial
Chutima Phuaksaman, Katechan Jampachaisri, Klaita Srisingh
Clin Exp Pediatr. 2025;68(9):690-699.   Published online April 1, 2025
This study assessed the effects of vitamin C on children with community-acquired pneumonia (CAP). Vitamin C supplementation improved clinical symptoms within 48–72 hours compared to placebo but did not reduce the length of hospital stay (LOS). These findings suggest that vitamin C is beneficial for managing CAP severity, but does not affect LOS.


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