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"Most downloaded" Articles are from the articles published in 2023 during the last six months.

Original Article
Neonatology (Perinatology)
Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates   (347 times)
Kulthida Baingam, Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate
Clin Exp Pediatr. 2025;68(2):178-184.   Published online November 13, 2024
Question: Can sigh breaths (Sighs) application during high-frequency oscillatory ventilation (HFOV) decrease partial pressure of carbon dioxide (PaCO2) levels?
Finding: The mean PaCO2 level after Sighs during HFOV was significantly decreased compared to that after HFOV alone (mean difference, -3.6 mmHg).
Meaning: HFOV plus Sighs functionality can reduce PaCO2 levels. However, further studies are required to conclusively determine the effects of Sighs.
Review Article
Developmental and Behavioral Medicine
Comprehensive evaluation of the child with global developmental delays or intellectual disability   (333 times)
Abdullah Nasser Aldosari, T. Saeed Aldosari
Clin Exp Pediatr. 2024;67(9):435-446.   Published online May 29, 2024
· A detailed history and comprehensive physical examination remain the cornerstones for establishing a diagnosis of global developmental delay/intellectual disability (GDD/ID).
· Comprehensive surveillance and screening programs play a significant role in the early detection of GDD.
· Whole-exome sequencing is highly recommended as first- or second-line testing for individuals with idiopathic GDD/ID.
· Early intervention by a well-versed multidisciplinary team can significantly improve the outcomes and prognosis of GDD/ID.
Infection
Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment   (297 times)
Ki Wook Yun
Clin Exp Pediatr. 2024;67(2):80-89.   Published online June 14, 2023
· Most commonly confirmed causes of community-acquired pneumonia (CAP) in children are Mycoplasma pneumoniae (8%–40%) and respiratory syncytial virus (15%–20%).
· Pyogenic bacteria, most commonly Streptococcus pneumoniae (40%–50%) and Streptococcus pyogenes (10%–25%), are detected in 2%–5% of children hospitalized with CAP.
· CAP should be diagnosed conservatively according to clinical and radiological criteria.
· The etiology should be identified via appropriate test result interpretation.
Original Article
Neonatology (Perinatology)
Characterization of gut microbiota in very low birth weight infants with versus without bronchopulmonary dysplasia   (291 times)
Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate, Kamonnut Singkhamanan, Komwit Surachat
Clin Exp Pediatr. 2025;68(7):503-511.   Published online February 26, 2025
Question: Does the gut microbiota differ between very low birth weight (VLBW) infants with versus without bronchopulmonary dysplasia (BPD)?
Finding: Common respiratory pathogens were notably elevated in the BPD group, whereas anaerobic and butyrate-producing taxa, key components of postbiotics, were dominant in the non-BPD group.
Meaning: In gut-lung communication, the interplay between the intestinal and respiratory systems may implicate pro- and postbiotics in VLBW infants with BPD.
Review Article
Neonatology (Perinatology)
Need for national guidance regarding proactive care of infants born at 22–23 weeks' gestation   (289 times)
Ga Won Jeon
Clin Exp Pediatr. 2025;68(1):53-61.   Published online November 13, 2024
With advancements in neonatal intensive care, the limit of viability has shifted to 22–23 weeks' gestation, whose survival rates vary across countries and institutions. These rates are not static and can be improved through the proactive and centralized care guided by national protocols, including maternal transfer to high-activity regions with better neonatal intensive care practices before delivery.
Cardiology
Heart failure in children and adolescents: an update on diagnostic approaches and management   (247 times)
Amit Agrawal, Dalwinder Janjua, Abdulrahman Ahmed Alsayed Ali Zeyada, Ahmed Taher Elsheikh
Clin Exp Pediatr. 2024;67(4):178-190.   Published online June 19, 2023
· Pediatric heart failure (PHF) is a clinical syndrome featuring various symptoms (shortness of breath, ankle swelling, fatigue) and signs (pulmonary crackles, peripheral edema).
· Congenital heart diseases are the most common underlying etiology of PHF, whereas myocarditis and primary cardio-myopathies are common in children without structural ab-normalities.
· PHF pathophysiology is complex and multifactorial and varies by etiology and age.
· PHF management includes decongestive therapy, treatment of underlying causes, preventing progression, and managing pulmonary or systemic obstructions.
· Drugs should be chosen based on pharmacodynamics, clinical manifestations, hemodynamic state, and renal function.
Editorial
Neonatology (Perinatology)
Intermittent sigh breaths during high-frequency oscillatory ventilation among newborn infants   (192 times)
Ga Won Jeon
Clin Exp Pediatr. 2025;68(7):486-488.   Published online April 16, 2025
Intermittent sigh breaths during high-frequency oscillatory ventilation can improve ventilation and oxygenation by enhancing lung recruitment. Although research on this approach in newborn infants is limited, some published studies suggest that sigh breaths are generally applied at a rate of 2–3 breaths/min with an inspiratory time of 0.5–1 second and pressure of current mean airway pressure + 5 cmH2O (maximum, 30 cmH2O).
Original Article
Developmental and Behavioral Medicine
Characteristics of temper tantrums in 1–6-year-old children and impact on caregivers   (188 times)
Warangkana Prutipaisan, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho
Clin Exp Pediatr. 2025;68(2):170-177.   Published online November 13, 2024
Question: What are common tantrum behaviors in preschool children, and how frequently are problematic behaviors observed? Do problematic tantrums have a different emotional impact on caregivers compared to typical tantrums?
Finding: Temper tantrums are common in preschool children, and verbal tantrums are the most common type.
Meaning: Problematic tantrums, defined as tantrums exhibiting aggressive physical behavior, long duration (>15 minutes), or frequent occurrence (>3 days/wk), significantly affected caregivers’ emotions.
Review Article
General Pediatrics
Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis   (183 times)
Ker Yang Chua, Ker Yung Chua, Karuthan Chinna, Chooi Ling Lim, Maheeka Seneviwickrama
Clin Exp Pediatr. 2025;68(2):115-126.   Published online November 13, 2024
The incidence of childhood obesity is increasing worldwide. National surveys in Malaysia have shown similar trends. This review aimed to increase our understanding of the prevalence and associated factors of childhood overweight, obesity, and excess weight in Malaysia. A systematic review and meta-analysis were conducted of studies reporting the prevalence of overweight and obesity in Malaysian children aged <18 years....
Infection
Pathogenetic and etiologic considerations of febrile seizures   (171 times)
Ji Yoon Han, Seung Beom Han
Clin Exp Pediatr. 2023;66(2):46-53.   Published online January 13, 2023
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.
Neonatology (Perinatology)
Updates in neonatal resuscitation: routine use of laryngeal masks as an alternative to face masks   (168 times)
Eun Song Song, Ga Won Jeon
Clin Exp Pediatr. 2024;67(5):240-246.   Published online July 11, 2023
In neonatal resuscitation:
· Laryngeal masks are recommended when endotracheal intubation or positive-pressure ventilation fails.
· Laryngeal masks are useful even during chest compressions.
· Laryngeal masks aid neonates >34 weeks’ gestation and/or with a birth weight >2 kg.
· Main usage barriers include limited experience (81%), preference for endotracheal tubes (57%), and lack of awareness (56%).
· Second-generation laryngeal masks have a built-in esophageal drainage tube that prevents regurgitation into the glottis, and an orogastric tube can be inserted within the esophageal drainage tube to protect against gastric inflation.
Original Article
Neonatology (Perinatology)
Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis   (160 times)
Asha P. Shetty, Kurvatteppa Halemani, Alwin Issac, Latha Thimmappa, Sanjay Dhiraaj, Radha K, Prabhaker Mishra, Vijai Datta Upadhyaya
Clin Exp Pediatr. 2024;67(2):104-115.   Published online November 14, 2023
Question: What emotions do parents experience when their newborns are admitted to the neonatal intensive care unit (NICU)?
Finding: Mothers experienced more anxiety (51%), depression (31%), and stress (41%) symptoms than fathers (26%, 12%, and 22%, respectively).
Meaning: Parents often experience anxiety, stress, and depression following NICU admission. Healthcare workers are responsible for providing regular parental counseling.
Review Article
Allergy
Eosinophil-derived neurotoxin levels can predict allergic disease development and atopic march in children   (151 times)
Zak Callaway, Chang-Keun Kim
Clin Exp Pediatr. 2025;68(6):398-405.   Published online February 3, 2025
· Allergic march occurs in a subset of children, beginning with atopic dermatitis and progressing to food allergies, allergic rhinitis, and/or asthma. Its early diagnosis is important to slowing its progression.
· Eosinophil-derived neurotoxin (EDN), an excellent biomarker of eosinophil activity, is often elevated in allergic diseases.
· EDN levels have been used to predict allergic disease development and diagnose, treat, and monitor allergic diseases.
Original Article
General Pediatrics
Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia   (150 times)
Abdul Wahab, Ida Safitri Laksanawati, Retna Siwi Padmawati, Asal Wahyuni Erlin Mulyadi, Wahyu Triadmajani, Jarir At Thobari
Clin Exp Pediatr. 2025;68(3):228-237.   Published online November 13, 2024
Question: Do community members and health providers show different level of knowledge, attitude, and practice towards dengue vaccine?
Finding: These 2 groups only differed in practice component, while the knowledge and attitude constituents were relatively low for both.
Meaning: There is an urgent need to deliver educational interventions to raise awareness of community members and health providers regarding dengue vaccination.
Review Article
Allergy
Global burden of asthma among children and adolescents with projections to 2050: a comprehensive review and forecasted modeling study   (143 times)
Tae Hyeon Kim, Hyunjee Kim, Jiyeon Oh, Soeun Kim, Michael Miligkos, Dong Keon Yon, Nikolaos G Papadopoulos
Clin Exp Pediatr. 2025;68(5):329-343.   Published online April 22, 2025
Pediatric asthma can persist to adulthood and must be effectively managed. This review examined the prevalence of asthma among individuals younger than 20 years and revealed a decline from 1990 to 2021, higher rates in males, and a peak in children aged 5–9 years. Despite a projected continued decrease in prevalence by 2050, asthma will remain a significant health concern for children and adolescents.
Neonatology (Perinatology)
Treatment of congenital cytomegalovirus infection   (137 times)
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(9):384-394.   Published online December 28, 2022
· 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.
Original Article
Nutrition
Effect of probiotics plus zinc supplementation on clinical outcomes of infants and children with acute infectious diarrhea: a randomized controlled trial   (137 times)
Deldar Morad Abdulah, Saad Jbraeil Sulaiman, Zaid Waad Ahmed
Clin Exp Pediatr. 2024;67(4):203-212.   Published online February 19, 2024
Question: Does zinc supplementation along with probiotics affect disease severity or clinical outcomes of children with acute diarrhea?
Findings: This study indicated that zinc supplementation and probiotics had no effect on clinical improvement or disease severity among pediatric patients with acute diarrhea.
Meaning: Children who received probiotics plus zinc recovered faster than those who received probiotics only.
Review Article
Developmental and Behavioral Medicine
Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates   (130 times)
Tae Hoon Eom, Young-Hoon Kim
Clin Exp Pediatr. 2024;67(1):26-34.   Published online June 14, 2023
· Primary pediatricians should play a key role in the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD).
· The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has lowered the diagnostic threshold for older teens and adults and a comorbid diagnosis with autism is now allowed.
· The American Academy of Pediatrics had added recommendation-related comorbid conditions in its guideline and the Society of Developmental and Behavioral Pediatrics recently developed a complex ADHD guideline.
· The European ADHD Guideline Group recently developed a guideline for managing ADHD during the coronavirus disease 2019 pandemic.
Other
Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies   (129 times)
Rogers Wainkwa Chia, Ntegang Venant Atem, Jin-Yong Lee, Jihye Cha
Clin Exp Pediatr. 2025;68(1):1-15.   Published online November 6, 2024
· Milk and formula are common sources of microplastic in infants.
· Water and air are the most common sources of microplastic pollution from infancy to adolescence.
· Microplastic use by children of all ages can cause cell damage and affect their health.
· Microplastics present in children can be quantified using a stereomicroscope and characterized using micro- Fourier transform infrared spectroscopy.
Neonatology (Perinatology)
Demographic transition in South Korea: implications of falling birth rates   (118 times)
Chae Young Kim, Sung-Hoon Chung
Clin Exp Pediatr. 2024;67(10):498-509.   Published online June 27, 2024
· Since 1960, South Korea's TFR decreased from 6.33 to 0.78 in 2022, below the 2.1 replacement level since 1983, with women's average age at first marriage rising to 31.3 in 2022.
· Policies needed: financial incentives, longer parental leave, better childcare.
· The U.S. (15.3% immigrants) and Germany (18.8%) use immigration to maintain demographic stability, a strategy South Korea is considering.
Other
Hearing loss in neonates and infants   (111 times)
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.
Gastroenterology
Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children   (110 times)
Yu Kyung Cho, Jin Lee, Chang Nyol Paik
Clin Exp Pediatr. 2023;66(9):377-383.   Published online August 21, 2023
· 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.
Original Article
Infection
Enteric pathogens implicated in acute infectious diarrhea among young children in resource-limited region with rapidly growing population: a hospital-based cross-sectional study   (102 times)
Aseel Mahmood Ibrahim Al-Mashahedah, Randa Mohammed Dhahi
Clin Exp Pediatr. 2025;68(5):379-387.   Published online December 23, 2024
Question: What are the most common enteric pathogens in acute diarrhea among children younger than 5 years of age, and which age group is most susceptible?
Finding: Bacteria were the most common causative microorganisms of diarrhea, followed by viruses, parasites, and fungi. The 1–2-year age group was the most commonly affected.
Meaning: There is a need to formulate preventive strategies targeting children exposed to enteric pathogens to limit diarrhea.
Review Article
Gastroenterology
Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children   (101 times)
Byung-Ho Choe
Clin Exp Pediatr. 2025;68(3):185-198.   Published online November 13, 2024
Eosinophilic gastrointestinal disorders (EGIDs) often coexist with functional gastrointestinal disorders (FGIDs) and other IgE or non-IgE mediated GI diseases. Diagnosing EGIDs requires a high index of suspicion and a comprehensive approach to differentiate them from conditions like inflammatory bowel disease. Tests such as fecal calprotectin and biopsies aid in severe cases. Maintaining a food diary helps identify triggers for long-term elimination. Awareness and education are key to effective management.
Editorial
Hematology
Absolute versus functional iron deficiency   (95 times)
Hye Lim Jung
Clin Exp Pediatr. 2025;68(2):138-140.   Published online November 13, 2024
· Iron deficiency (ID), the most common cause of anemia, can be classified into absolute and functional types. Absolute ID is a state of low total body iron, while functional ID is a state of imbalance between iron demand and iron availability due to inflammation and/or infection.
· ID is diagnosed by serum ferritin and transferrin saturation levels.
Review Article
Neurology
Pediatric syncope: pearls and pitfalls in history taking   (94 times)
Jung Sook Yeom, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(3):88-97.   Published online February 15, 2023
An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking.
Original Article
Pulmonology
Clinical course of children with postinfectious bronchiolitis obliterans with versus without comorbid bronchopulmonary dysplasia   (94 times)
Lamia Medghoul, Julien Grosjean, Christophe Marguet, Hortense Petat
Clin Exp Pediatr. 2025;68(7):497-502.   Published online April 1, 2025
Question: Postinfectious bronchiolitis obliterans (PIBO) is a chronic respiratory disease that typically develops in children after a severe respiratory infection. Bronchopulmonary dysplasia (BPD) is often comorbid in patients with PIBO.
Finding: Corticosteroid pulse therapy effectively manages PIBO with or without comorbid BPD, significantly reducing exacerbations and decreasing the daily requirement for inhaled corticosteroids.
Meaning: Therapeutic effects of corticosteroid pulses are rapid and sustained over time, in both groups.
Review Article
Critical Care Medicine
Protocolized sedation may reduce ventilation and sedation requirements in the pediatric intensive care unit: a systematic review and meta-analysis   (91 times)
Ambrus Szemere, Alíz Fazekas, Anna Réka Sebestyén, Rani Ezzeddine, Veronika Upor, Marie Anne Engh, Péter Hegyi, Zsolt Molnár, Klára Horváth
Clin Exp Pediatr. 2025;68(6):406-416.   Published online February 19, 2025
Protocolized sedation may reduce ventilation requirements, pediatric intensive care unit length of stay, and sedative exposure. However, it may increase the likelihood of unplanned extubation, highlighting the importance of incorporating preventive measures to mitigate this risk.
Allergy
Comparison and review of international guidelines for treating asthma in children   (90 times)
Eui Jeong Roh
Clin Exp Pediatr. 2024;67(9):447-455.   Published online August 20, 2024
Asthma is the most common chronic disease among children. Although asthma in children may spontaneously improve, it continues into adulthood in many cases. Therefore, appropriate disease management and medication are essential. Consistent and objective guidelines are needed to manage pediatric asthma and related adverse reactions.
Original Article
General Pediatrics
The role of serum zinc and selenium levels in etiology of febrile seizures   (90 times)
Yavuz Ataş, Hatice Gamze Poyrazoğlu
Clin Exp Pediatr. 2025;68(5):388-394.   Published online January 13, 2025
Zinc may play a key role in preventing febrile seizures by increasing the seizure threshold and reducing oxidative stress. Incorporating zinc supplements into treatment could help protect children from the adverse effects of febrile seizures and improve their overall outcomes.


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