Clinical and Experimental Pediatrics

Review Article

Infection

Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment (359 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.

DOI: https://doi.org/10.3345/cep.2022.01452

Developmental and Behavioral Medicine

Comprehensive evaluation of the child with global developmental delays or intellectual disability (268 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.

DOI: https://doi.org/10.3345/cep.2023.01697

Original Article

Neonatology (Perinatology)

Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates (250 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.

DOI: https://doi.org/10.3345/cep.2024.01011

Review Article

Cardiology

Heart failure in children and adolescents: an update on diagnostic approaches and management (215 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

Web of Science 1 Crossref 2

· 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.

DOI: https://doi.org/10.3345/cep.2023.00528

Neonatology (Perinatology)

Need for national guidance regarding proactive care of infants born at 22–23 weeks' gestation (187 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.

DOI: https://doi.org/10.3345/cep.2024.01277

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

Web of Science 6 Crossref 9

· 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.

DOI: https://doi.org/10.3345/cep.2021.01039

Other

Microplastic and human health with focus on pediatric well-being: a comprehensive review and call for future studies (163 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.

DOI: https://doi.org/10.3345/cep.2023.01739

Original Article

Nutrition

Effect of probiotics plus zinc supplementation on clinical outcomes of infants and children with acute infectious diarrhea: a randomized controlled trial (138 times)

Deldar Morad Abdulah, Saad Jbraeil Sulaiman, Zaid Waad Ahmed

Clin Exp Pediatr. 2024;67(4):203-212. Published online February 19, 2024

Web of Science 1 Crossref 2

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.

DOI: https://doi.org/10.3345/cep.2023.01340

Review Article

Endocrinology

Growth plate closure and therapeutic interventions (134 times)

Ja Hyang Cho, Hae Woon Jung, Kye Shik Shim

Clin Exp Pediatr. 2024;67(11):553-559. Published online October 28, 2024

Height gains result from longitudinal bone growth. Upon adequate growth, growth plate closure limits longitudinal bone growth. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure and increase human height. The development of more effective therapeutic modalities for short stature, precocious puberty, and skeletal dysplasia is anticipated.

DOI: https://doi.org/10.3345/cep.2023.00346

Pulmonology

Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents (131 times)

Eun Lee, Kyunghoon Kim, You Hoon Jeon, In Suk Sol, Jong Deok Kim, Taek Ki Min, Yoon Ha Hwang, Hyun-Ju Cho, Dong In Suh, Hwan Soo Kim, Yoon Hee Kim, Sung-Il Woo, Yong Ju Lee, Sungsu Jung, Hyeon-Jong Yang, Gwang Cheon Jang

Clin Exp Pediatr. 2024;67(9):418-426. Published online January 23, 2024

· We suggest offering long-term macrolides to children with noncystic fibrosis bronchiectasis with frequent exacerbations (conditional recommendation, moderate quality of evidence).
· We do not recommend the routine use of mucolytic agents, inhaled corticosteroids, or nonsteroidal anti-inflammatory drugs to prevent exacerbation of bronchiectasis in children (inconclusive, very low quality of evidence).
· We recommend the use of nebulized hypertonic saline to prevent exacerbations and improve the lung function of children with noncystic fibrosis bronchiectasis (weak recommendation, moderate quality of evidence).

DOI: https://doi.org/10.3345/cep.2023.00871

Neonatology (Perinatology)

Demographic transition in South Korea: implications of falling birth rates (130 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.

DOI: https://doi.org/10.3345/cep.2023.01599

General Pediatrics

Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis (128 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....

DOI: https://doi.org/10.3345/cep.2024.00899

Allergy

Comparison and review of international guidelines for treating asthma in children (123 times)

Eui Jeong Roh

Clin Exp Pediatr. 2024;67(9):447-455. Published online August 20, 2024

Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2022.01466

Developmental and Behavioral Medicine

Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates (121 times)

Tae Hoon Eom, Young-Hoon Kim

Clin Exp Pediatr. 2024;67(1):26-34. Published online June 14, 2023

Web of Science 6 Crossref 7

· 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.

DOI: https://doi.org/10.3345/cep.2021.01466

Rheumatology

Double-negative T cells in pediatric rheumatic diseases (121 times)

Dimitri Poddighe, Tilektes Maulenkul, Kuanysh Dossybayeva, Gulsamal Zhubanova, Zaure Mukusheva, Lyudmila Akhmaltdinova

Clin Exp Pediatr. 2024;67(12):632-640. Published online September 12, 2024

Web of Science 1 Crossref 1

Double-negative T (DNT) cells appear to be increased in several pediatric rheumatic diseases and this finding may be correlated with disease activity to some extent. However, due to significant heterogeneity in several methodological aspects, further investigations in rheumatic children are needed to assess the potential relevance of DNT cells as biomarkers and clarify their immunopathological role.

DOI: https://doi.org/10.3345/cep.2023.01760

Original Article

Pulmonology

Efficacies of different treatment strategies for infants hospitalized with acute bronchiolitis (120 times)

Hyeri Jeong, Dawon Park, Eun Kyo Ha, Ju Hee Kim, Jeewon Shin, Hey-Sung Baek, Hyunsoo Hwang, Youn Ho Shin, Hye Mi Jee, Man Yong Han

Clin Exp Pediatr. 2024;67(11):608-618. Published online October 28, 2024

· This study analyzed 45 randomized controlled trials (5,061 participants, 13 interventions) of the comparative efficacies of treatments for acute bronchiolitis in infants.
· Inhalation therapy with epinephrine and hypertonic saline significantly reduced the length of hospital stay compared with normal saline.
· Hypertonic saline had the greatest ability to improve the clinical severity score of bronchiolitis in infants younger than 2 years of age.

DOI: https://doi.org/10.3345/cep.2023.01676

Review Article

Endocrinology

Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis (112 times)

Maya L. Nasser, Joseph Nasr, Reem B. Zalloum, Nathanael Q.E. Yap, Natalie E. Bourdakos, Shahid Miangul, Tara A. Betts, Hayato Nakanishi, Christian A. Than, Serge Jabbour

Clin Exp Pediatr. 2024;67(10):486-497. Published online June 27, 2024

· The safety and efficacy of the two-bag versus one-bag system for treating patients with diabetic ketoacidosis (DKA) < 21 years remains unestablished.
· Our meta-analysis demonstrated similar safety outcomes but sooner DKA resolution and shorter mean response time for intravenous fluid changes for the two-bag system.
· This preliminary evidence suggests that the two-bag system has some advantages in efficacy, but further studies are needed to evaluate their extent.

DOI: https://doi.org/10.3345/cep.2023.01536

Original Article

General Pediatrics

Nonpharmacological interventions for managing postoperative pain and anxiety in children: a randomized controlled trial (111 times)

Edlin Glane Mathias, Mamatha Shivananda Pai, Vijay Kumar, Dinesh Narayanakurup, Malavika Kulkarni, Vasudeva Guddattu, Ann-Cathrine Bramhagen, Baby S Nayak, Anice George

Clin Exp Pediatr. 2024;67(12):677-685. Published online October 31, 2024

Question: What is the effect of nonpharmacological interventions on postoperative pain and anxiety among children.
Finding: Nurse-provided distraction interventions reduce pain and anxiety among pediatric surgical patients.
Meaning: The findings suggest that nonpharmacological interventions provided postoperatively to children reduce their pain and anxiety levels.

DOI: https://doi.org/10.3345/cep.2023.01690

Review Article

Other

Hearing loss in neonates and infants (107 times)

Goun Choe, Su-Kyoung Park, Bong Jik Kim

Clin Exp Pediatr. 2023;66(9):369-376. Published online January 9, 2023

Web of Science 7 Crossref 8

· 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.

DOI: https://doi.org/10.3345/cep.2022.01011

Allergy

Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis (107 times)

Kiwako Yamamoto-Hanada, Yukihiro Ohya

Clin Exp Pediatr. 2024;67(10):477-485. Published online June 14, 2023

Web of Science 6 Crossref 7

To prevent food allergy in infants, based on the dual allergen exposure hypothesis, we recommend a personalized approach consisting of both skin intervention (eczema treatment to achieve early remission and well-controlled skin without eczema to prevent percutaneous immunoglobulin E sensitization) and oral intervention (early allergenic food introduction).

DOI: https://doi.org/10.3345/cep.2023.00045

Original Article

Endocrinology

Efficacy of leuprolide acetate versus triptorelin pamoate administered every 3 months for treatment of central precocious puberty (105 times)

Thanaporn Thaneetrakool, Suphab Aroonparkmongkol, Nattakarn Numsriskulrat, Vichit Supornsilchai, Suttipong Wacharasindhu, Khomsak Srilanchakon

Clin Exp Pediatr. 2025;68(1):91-96. Published online November 6, 2024

Question: What are the differences in efficacy between leuprolide acetate and triptorelin pamoate administered every 3 months for the treatment of central precocious puberty (CPP)?
Finding: There were no significant intergroup differences in luteinizing hormone suppression or predicted adult height at the end of treatment in girls with CPP.
Meaning: Leuprolide acetate and triptorelin pamoate have comparable efficacy for treating CPP.

DOI: https://doi.org/10.3345/cep.2024.00822

Review Article

Neonatology (Perinatology)

Neonatal family-centered care: evidence and practice models (100 times)

Juyoung Lee

Clin Exp Pediatr. 2024;67(4):171-177. Published online June 14, 2023

Web of Science 3 Crossref 4

· Concrete evidence exists of early parent-infant attachment supported by family-centered care (FCC) in the neonatal intensive care unit.
· FCC involves the parents’ presence and participation in the infant’s care and decision-making.
· A private and comfortable space should be provided. A single-family room is ideal; however, a quiet space with a recliner can be a good alternative.
· Care culture changes and staff training are required.

DOI: https://doi.org/10.3345/cep.2023.00367

Updates in neonatal resuscitation: routine use of laryngeal masks as an alternative to face masks (98 times)

Eun Song Song, Ga Won Jeon

Clin Exp Pediatr. 2024;67(5):240-246. Published online July 11, 2023

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2023.00619

Critical Care Medicine

Recent updates on systemic treatment of atopic dermatitis (97 times)

Jiyoung Ahn

Clin Exp Pediatr. 2024;67(11):580-588. Published online November 1, 2024

Atopic dermatitis (AD) is a complex disease with multifactorial pathogenesis and variable clinical presentation. Up to one-fifth of patients with AD develop moderate to severe disease that is often refractory to classical therapies and can compromise quality of life. This review summarizes recent clinical evidence on biological agents and small-molecule immunotherapies for the treatment of AD.

DOI: https://doi.org/10.3345/cep.2024.00339

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 (96 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

Web of Science 5 Crossref 11

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.

DOI: https://doi.org/10.3345/cep.2023.00486

Review Article

General Pediatrics

Protecting our future: environmental hazards and children’s health in the face of environmental threats: a comprehensive overview (96 times)

Jungha Lee, Hyo-Bin Kim, Hun-Jong Jung, Myunghee Chung, So Eun Park, Kon-Hee Lee, Won Seop Kim, Jin-Hwa Moon, Jung Won Lee, Jae Won Shim, Sang Soo Lee, Yunkoo Kang, Young Yoo; The Environmental Health Committee of the Korean Pediatric Society

Clin Exp Pediatr. 2024;67(11):589-598. Published online October 31, 2024

Crossref 1

· Exposure to air pollutants cause allergic and respiratory diseases as well as chronic kidney disease.
· Adequate physical activity and proper nutrition are essential for children to maintain good health.
· We must educate people about the harmful effects of noise, blue light, heavy metals and smoke.
· Government and society must actively decrease environ-mental hazards.

DOI: https://doi.org/10.3345/cep.2023.01578

Original Article

Neonatology (Perinatology)

Short-term outcomes of oropharyngeal administration of colostrum in preterm neonates: a double-blind placebocontrolled randomized trial (92 times)

Ameneh Lamsehchi, Maryam Shokouhi Solgi, Mohammad Kazem Sabzehei, Behnaz Basiri, Elahe Talebi Ghane, Kiana Kimiaei Asadi, Sina Azadnajafabad

Clin Exp Pediatr. 2025;68(1):73-79. Published online October 31, 2024

Question: What are the short-term outcomes of oropharyngeal administration of colostrum (OAC) in preterm neonates?
Finding: This study demonstrated the significantly lower rates of necrotizing enterocolitis, clinically suspected sepsis, shorter hospital stay, period to full enteral feeding, and antibiotic therapy period in the OAC group.
Meaning: This trial may further expand the clinical application of OAC in premature infants to reduce their length of hospital stay and complications.

DOI: https://doi.org/10.3345/cep.2024.00591

Review Article

Gastroenterology

Current diagnosis and image-guided reduction for intussusception in children (90 times)

Jisun Hwang, Hee Mang Yoon, Pyeong Hwa Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho

Clin Exp Pediatr. 2023;66(1):12-21. Published online July 4, 2022

Web of Science 6 Crossref 6

· Intussusception, the most common cause of small bowel obstruction in young children, has an overall incidence in Korea of 28.3 cases per 100,000 person-years.
· Its cause is idiopathic inmost cases, although viral or bacterial gastroenteritis has beenpostulated as a cause. Approximately 4% of children have pathological lead points for intussusception, and Meckel’s diverticulum is the most common cause.
· Intussusception in preterm infants is extremely rare. Older children (>5 years of age) are at increased risk of pathological lead points.

DOI: https://doi.org/10.3345/cep.2021.01816

Developmental and Behavioral Medicine

Screen time among preschoolers: exploring individual, familial, and environmental factors (90 times)

Sangha Lee, Donghee Kim, Yunmi Shin

Clin Exp Pediatr. 2024;67(12):641-650. Published online September 12, 2024

This systematic review examined the correlation between screen time and various factors in preschoolers. Findings suggest that media parenting, including setting appropriate media limits, is crucial in protecting against excessive screen exposure. However, limited research has been done on the impact of family and personal factors, particularly with the increasing use of portable devices among young children.

DOI: https://doi.org/10.3345/cep.2023.01746

Endocrinology

Lifelong medical challenges and immunogenetics of Turner syndrome (87 times)

Won Kyoung Cho

Clin Exp Pediatr. 2024;67(11):560-568. Published online July 31, 2024

Web of Science 2 Crossref 2

· This summary emphasizes the importance of the early diagnosis of Turner syndrome (TS) and presents a multidisciplinary approach to its prevention and management, high-lighting the need for customized care.
· Advancements in immunogenetic research may improve our understanding of TS and improve its outcomes.
· TS encompasses a wide array of medical challenges, including cardiovascular, endocrine, autoimmune, and mental health issues, as well as a heightened cancer risk.

DOI: https://doi.org/10.3345/cep.2024.00430

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