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

Review Article
Neonatology (Perinatology)
Strategies to support language development in neonatal intensive care unit: a narrative review   (68 times)
Ju Sun Heo, Ee-Kyung Kim
Clin Exp Pediatr. 2024;67(12):651-663.   Published online November 6, 2024
· Preterm infants often experience speech and language development delays during early childhood, impacting children's ultimate outcomes.
· Promoting breastfeeding, increasing parent-infant interactions in a single-family room, promoting a nurturing language environment by parental book reading and language interventions, and parent-integrated interventions in the neonatal intensive care unit could potentially enhance children's language development.
· Integrating these strategies through family-centered care is essential.
Original Article
Hematology
Treatment and clinical outcomes of pediatric autoimmune hemolytic anemia: real-world single-center data from Korea   (68 times)
Young Dai Kwon, Eun Sun Jung, Yeon Jung Lim
Clin Exp Pediatr. 2025;68(7):522-529.   Published online April 16, 2025
Question: Can pediatric autoimmune hemolytic anemia (AIHA) be effectively managed using first-line steroids?
Finding: In this single-center study, pediatric patients with AIHA achieved normal hemoglobin levels within 16.5 days (range, 9.0–22.0 days) of first-line steroid treatment and maintained effective responses for 2 months.
Meaning: These outcomes highlight the efficacy of steroid treatment in pediatric versus adult AIHA and underscore the need for multicenter trials to establish standardized treatment guidelines.
Editorial
Nutrition
Zinc as a treatment modality for acute infectious diarrhea in children   (67 times)
Ji Sook Park
Clin Exp Pediatr. 2025;68(3):223-224.   Published online October 31, 2024
· Prevention and management of dehydration is the major goal of treatment in acute infectious diarrhea in children.
· Zinc could be effective as an adjuvant therapy in reducing the duration of acute infectious diarrhea in malnourished children.
General Pediatrics
Artificial intelligence in pediatric healthcare: bridging potential, clinical practice, and ethical considerations   (67 times)
Yoon Lee, Seohyun Hong, Dong Keon Yon
Clin Exp Pediatr. 2025;68(9):652-655.   Published online August 28, 2025
· Artificial intelligence (AI) holds transformative potential for pediatric healthcare, with applications spanning prevention, diagnosis, treatment, and follow-up across diverse subspecialties; however, ethical concerns, scarcity of pediatric- specific data, and limited funding remain significant challenges.
· International consensus on pediatric AI guidelines, expanding child-specific datasets, and incorporating explainable AI are essential to ensure safety and trust.
· Multicenter collaboration and increased investment can address these gaps, enabling equitable, reliable, and pediatric- centered AI solutions.
Review Article
Pulmonology
Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents   (66 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).
Clinical Note
Genetics and Metabolism
Expanding genotype-phenotype correlation of Kenny-Caffey syndrome type 1   (66 times)
Manuela Lo Bianco, Federica Sipala, Xena Giada Pappalardo, Gaia Fusto, Roberta Rizzo, Federico Favata, Carla Cimino, Silvia Marino, Martino Ruggieri, Agnese Suppiej, Simone Ronsisvalle, Raffaele Falsaperla
Clin Exp Pediatr. 2025;68(8):616-619.   Published online May 12, 2025
Review Article
Other
Hearing loss in neonates and infants   (65 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.
Immunology
NLRP3 inflammasome: a key player in neonatal brain injury   (64 times)
Cagla Kiser, Ilkcan Ercan, Defne Engur, Sermin Genc
Clin Exp Pediatr. 2025;68(7):475-485.   Published online April 1, 2025
Hypoxic-ischemic encephalopathy is the major cause of neonatal brain injury. NOD-like receptor family pyrin domain containing 3 inflammasome activation leads to neuroinflammation, which significantly affects newborn mortality. The establishment of preventive and therapeutic strategies against brain damage requires a thorough understanding of the mechanisms underlying neuroinflammation and inflammasome activation in the neonatal brain.
Original Article
General Pediatrics
Comparative analysis of goal attainment for helmet therapy versus conservative management for positional plagiocephaly in infants   (64 times)
Bjoern Vogt, Ariane Deutschle, Georg Gosheger, Adrien Frommer, Andrea Laufer, Henning Tretow, Robert Roedl, Gregor Toporowski
Clin Exp Pediatr. 2025;68(11):892-900.   Published online October 2, 2025
Question: Is helmet therapy more effective than conservative management in treating positional plagiocephaly?
Finding: Both approaches reduced cranial asymmetry with comparable correction speed. Helmet therapy showed a trend toward greater severity reduction.
Meaning: Early treatment initiation was the strongest predictor of improvement. Helmet therapy may offer additional benefit in more severe cases.
Review Article
Allergy
New approaches to immunotherapy in house dust mite allergy   (63 times)
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,...
Original Article
General Pediatrics
The role of serum zinc and selenium levels in etiology of febrile seizures   (62 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.
Neonatology (Perinatology)
Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis   (61 times)
Emilly Henrique dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay
Clin Exp Pediatr. 2025;68(6):463-471.   Published online December 23, 2024
Question: Can adrenomedullin (ADM) or interleukin-6 (IL-6) detect late-onset neonatal sepsis (LOS) at admission (area under the curve [AUC]>0.90) as an early diagnostic marker?
Finding: Only IL-6 consistently distinguished survivors from nonsurvivors (AUC>0.90) on admission and antibiotic treatment days 3 and 7. C-reactive protein level identified infections from day 3 but failed to predict outcomes (AUC<0.70).
Meaning: IL-6 level can improve LOS diagnosis and prognosis.
Editorial
Neonatology (Perinatology)
The predetermined future: tackling South Korea’s total fertility rate crisis   (60 times)
Jin Kyu Kim
Clin Exp Pediatr. 2025;68(3):225-227.   Published online November 6, 2024
· South Korea faces a severe demographic crisis with the lowest global fertility rate. Despite significant investments, the total fertility rate continues to decline.
· It is necessary to fully mobilize national capabilities and execute comprehensive strategies that focus on both intangible and tangible values.
· Immediate and decisive action is essential to addressing these challenges effectively.
Review Article
Neurology
Pediatric syncope: pearls and pitfalls in history taking   (59 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
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   (59 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
General Pediatrics
Impact of screen exposure during pediatric ages including multifaceted aggravating factors: a literature review   (59 times)
Daniel González-Pérez, David Sebastián Huertas-Moreno, Manuela Granados-Pinilla, Sofía Hernandez-Rojas, Laura González-Rincon, Geraldine Hurtado-Garcia, Simón Grisales-Calle, María José González-Mariño, Luz Dary Gutierrez-Castañeda, Jhon Camacho-Cruz
Clin Exp Pediatr. 2025;68(10):751-760.   Published online September 24, 2025
Excessive screen time in children is linked to obesity, overweight, sedentary behavior, depression and mood disorders, myopia, behavioral changes, sleep disturbances, attention deficit hyperactivity disorder, among others. Polymorphisms in genes like FTO, CACNA1D, and DRD2 could further increase these risks. Implementing strategies such as limiting screen use, creating screen-free zones, and monitoring content is essential to mitigate adverse physical and mental health effects in the pediatric population.
Gastroenterology
Role of social media use in onset of functional gastrointestinal disorders in children   (58 times)
Mauro Cinquetti, Vanessa Dargenio, Michele Fingerle, Carolina Marchiotto, Marco Biasin, Massimo Pettoello Mantovani, Flavia Indrio
Clin Exp Pediatr. 2023;66(6):226-232.   Published online December 21, 2022
· Social media use can cause adverse health outcomes, including gastrointestinal disorders, in children and adolescents.
· Recent findings have shown a high prevalence of social media use and decreased well-being in patients with functional gastrointestinal disorders.
· The biopsychosocial nature of functional gastrointestinal disorders and the clear influence of social media on the psychosocial lives of children suggests the likely involvement of social media in their development.
Original Article
Nutrition
Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach   (57 times)
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.
Review Article
Nephrology (Genitourinary)
Effects of diethylene glycol contamination of pharmaceutical products on unexplained acute kidney injury in children: a systematic review   (57 times)
Sani Rachman Soleman, Muhammad Luthfi Adnan, Hilmi Ardian Sudiarto, Satria Bintang Mahathma, Alya Ayu Tazkia, Hana Afifah Firdaus, Alfreda Amelia Khotijah, Miranti Dewi Pramaningtyas, Emi Azmi Choironi
Clin Exp Pediatr. 2024;67(8):395-402.   Published online January 4, 2024
A recent unexplained acute kidney injury (AKI) outbreak due to pharmaceutical product contamination with diethylene glycol (DEG) raises public attention. Our study revealed that DEG-contaminated paracetamol causes unexplained AKI in children. However, paracetamol is not the only contaminated drug. Other drugs, such as cough expectorants, antihistamines, and sedatives, can also be affected. Other chemicals, such as ethylene glycol and propylene glycol, can also contribute to poisonings.
Neonatology (Perinatology)
Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants   (57 times)
Eduardo Cuestas, Alina Rizzotti
Clin Exp Pediatr. 2025;68(4):287-297.   Published online December 23, 2024
· Previous reviews of extrauterine growth restriction focused mainly on weight growth restriction caused by nutritional factors or pathological conditions.
· This review summarizes recent developments in the pathophysiology of nonnutritional length growth restriction in very preterm infants with focus on the impact of sustained neonatal inflammation on their short- and long-term outcomes.
· Further research is needed to investigate optimal strategies to improve length growth restriction in very preterm infants.
Original Article
Hematology
Hematopoietic stem cell transplantation in pediatric patients with type VI mucopolysaccharidosis   (57 times)
Vedat Uygun, Koray Yalçın, Hayriye Daloğlu, Seda Öztürkmen, Suna Çelen, Suleimen Zhumatayev, Gülsün Karasu, Akif Yeşilipek
Clin Exp Pediatr. 2025;68(8):601-607.   Published online March 11, 2025
Question: Could hematopoietic stem cell transplantation (HSCT) be an alternative to enzyme replacement therapy (ERT) for type VI mucopolysaccharidosis (MPS VI)?
Finding: HSCT is generally not offered due to reports of high toxicity and mortality. However, we detected fewer complications and graft-versus-host disease cases and no deaths with HSCT.
Meaning: HSCT is both less expensive than ERT and permanent; thus, it should be considered an alternative treatment for MPS VI.
Review Article
Allergy
Natural course of IgE-mediated food allergy in children   (56 times)
Kyunguk Jeong, Sooyoung Lee
Clin Exp Pediatr. 2023;66(12):504-511.   Published online June 14, 2023
· Dendritic, regulatory T, and regulatory B cells significantly contribute to the natural course of food allergy.
· Cow’s milk and hen’s egg allergies tend to resolve in earlier childhood but recent studies show that 50% of patients still persist into school age.
· The potential factors affecting the natural course of food allergy are age at diagnosis, symptom severity, sensitization status and its change rate, and external factors such as diet and interventions.
· There is a considerable possibility of food allergy outgrow if specific IgE levels are 2–5 kUA/L or less, but other factors such as age and recent symptoms should be considered together.
· With a clear understanding of the natural course of food allergy, pediatricians can provide appropriate assessment and interventions to our patients, and consequently can help patients overcome their food allergy and improve the social safety net.
Original Article
Neonatology (Perinatology)
Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study   (56 times)
Ajay Kumar, Nidhi Jain
Clin Exp Pediatr. 2025;68(7):539-545.   Published online February 26, 2025
Question: What are the outcomes of jaundiced neonates when phototherapy is discontinued at 2 different total serum bilirubin (TSB) thresholds?
Findings: The study involved 80 neonates, comparing a recommended TSB threshold and a lower threshold for phototherapy discontinuation. Results showed a 14.3% reinstitution rate of treatment, with no adverse outcomes.
Meaning: Careful posttreatment monitoring is essential when discontinuing phototherapy, and future research should consider updated guidelines like those from the American Academy of Pediatrics.
Neurology
Establishing an induced pluripotent stem cell bank using urine cells from pediatric patients with neurogenetic diseases   (56 times)
Hien Bao Dieu Thai, WonWoo Jung, Sol Choi, Woo Joong Kim, JangSup Moon, ByungChan Lim
Clin Exp Pediatr. 2025;68(8):569-577.   Published online April 1, 2025
Question: What can be used to create a reliable supply of somatic cells for induced pluripotent stem cells (iPSCs) generation and standardize procedures for building an iPSC bank for researching pediatric neurogenetic disorders?
Findings: Noninvasively acquired urine cells are a desirable cell source for iPSC reprogramming.
Meaning: An iPSC bank can be created from diverse patient cell sources and offer a useful resource for translating research results into clinical therapy for pediatric neurogenetic disorders.
Gastroenterology
Adenosine deaminase and interleukin-1 receptor antagonist genetic polymorphisms among obese children with versus without metabolic dysfunction-associated fatty liver disease   (56 times)
Hala M. Sakhr, Mohammed H. Hassan, Azza Mohamed Taha, Ali Helmi Bakri
Clin Exp Pediatr. 2025;68(10):808-818.   Published online May 29, 2025
Question: Is there an association between adenosine deaminase (ADA) G22A and interleukin-1 receptor antagonist (IL-1RN) genetic polymorphisms and pediatric metabolic dysfunction-associated fatty liver disease (MAFLD)?
Finding: The GG genotype and G allele of ADA G22A were significantly associated with obesity but not pediatric MAFLD, while the *1/*2 genotype of the IL-1RN gene was significantly associated with obesity and pediatric MAFLD.
Meaning: The IL-1RN gene may contribute to pediatric MAFLD.
Neurology
Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study   (55 times)
Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius
Clin Exp Pediatr. 2025;68(4):303-310.   Published online November 13, 2024
Question: What is the occurrence of pediatric stroke in Indonesia?
Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%).
Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims.
Perspective
General Pediatrics
Navigating the complex behavioral landscape of children in foster care and adopted families   (55 times)
Anisha Choi, Sandhya J. Kadam
Clin Exp Pediatr. 2025;68(8):620-623.   Published online May 12, 2025
Review Article
Hematology
Promising role of voxelotor in managing sickle cell disease in children: a narrative review   (54 times)
Amit Agrawal, Gaurav Jadon, Japna Singh, Dalwinder Janjua
Clin Exp Pediatr. 2025;68(2):106-114.   Published online November 13, 2024
Voxelotor has promising ability to increase hemoglobin levels and reduce hemolysis markers in patients with sickle cell disease (SCD). Several preclinical and phase II/III trials have demonstrated its efficacy, dose-dependent responses, and tolerability in children. Ongoing trials are assessing its safety and effectiveness in various populations, including children younger than 12 years. These findings suggest its potential as a disease-modifying drug, warranting further exploration of its role in SCD management.
Genetics and Metabolism
Development of orphan drugs for rare diseases   (52 times)
Han-Wook Yoo
Clin Exp Pediatr. 2024;67(7):315-327.   Published online June 28, 2023
· Orphan disease is a rare disease, primarily affecting newborn and children. Vast majority of orphan diseases has genetic background.
· Orphan disease is individually rare. But as a whole, it is not rare, becoming a great socioeconomic burden.
· The diagnosis of rare genetic disease has been problematic, but recent progress of genome analysis technologies makes it faster and more precise.
· There are many unmet needs as to the curative treatment. However, the number of treatable rare diseases is growingly increasing owing to the development of biotechnology.
· Most orphan drugs are extremely expensive because of numer ous hurdles during the process of drug development as well as small number of patients.
Endocrinology
Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis   (52 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.


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