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"Most downloaded" Articles are from the articles published in 2024 during the last six months.

Original Article
Hematology
Outcomes of hematopoietic stem cell transplantation for pediatric patients with transfusion-dependent thalassemia in Thailand   (57 times)
Kleebsabai Sanpakit, Kamala Laohverapanich, Bunchoo Pongtanakul, Nattee Narkbunnam, Chayamon Takpradit, Usanarat Anurathapan, Samart Pakakasama, Supanun Lauhasurayotin, Kanhatai Chiengthong, Thirachit Chotsampancharoen, Pornpun Sripornsawan, Piya Rujkijyanont, Duantida Songdej, Nongnuch Sirachainan, Suradej Hongeng
Clin Exp Pediatr. 2026;69(4):340-352.   Published online March 13, 2026
Question: Can hematopoietic stem cell transplantation (HSCT) cure pediatric transfusion-dependent thalassemia in Thailand? What influences its outcomes?
Finding: Among 266 HSCT procedures, 5-year overall survival and event-free survival rates were 91.3% and 81.0%, respectively. Outcomes were comparable between related and unrelated donors. Pre-HSCT ferritin >2,500 ng/mL, low CD34+ cell dose, and oral busulfan conditioning were associated with unfavorable survival. Longterm complications affected 22.7% of survivors.
Meaning: Optimizing pre-HSCT care, ensuring adequate grafting, and long-term surveillance are crucial.
Review Article
Developmental and Behavioral Medicine
Screen time among preschoolers: exploring individual, familial, and environmental factors   (56 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.
Neonatology (Perinatology)
Moving toward meaningful shared decision-making in neonatal care: clinical practice and policy implications in Korea   (55 times)
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.
Pulmonology
Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents   (54 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).
Original Article
Allergy
Maternal sleep disorders during pregnancy and subsequent risk of allergic diseases in Japanese children: the TMM BirThree Cohort Study   (54 times)
Ami Uematsu, Masatsugu Orui, Mami Ishikuro, Keiko Murakami, Aoi Noda, Genki Shinoda, Taku Obara, Shinichi Kuriyama
Clin Exp Pediatr. 2026;69(1):36-45.   Published online October 22, 2025
Question: Associations have been made between maternal sleep disorders during pregnancy and allergic diseases including bronchial asthma, atopic dermatitis, food allergy, and allergic conjunctivitis/rhinitis/hay fever in their children.
Finding: In the crude model, sleep disorders during pregnancy were associated with all examined allergic diseases in children. After adjustment, significant associations remained for atopic dermatitis and allergic conjunctivitis/rhinitis/hay fever.
Meaning: The study highlights associations between maternal sleep and child allergic diseases.
Clinical Note
Gastroenterology
Successful rescue after catastrophic bleeding of carotid artery pseudoaneurysm following button battery ingestion in a toddler   (53 times)
Manjit Kaur, Ujjal Poddar, Basant Kumar, Abdul Muzil Munshi, Rajanikant R. Yadav, Moinak Sen Sarma, Anshu Srivastava
Clin Exp Pediatr. 2025;68(12):1041-1044.   Published online October 22, 2025
Button battery (BB) ingestion is an increasing hazard. Catastrophic gastrointestinal bleeding due to pseudoaneurysm rupture following BB impaction is often fatal. Here we report the case of an unwitnessed BB ingestion in an 18-month-old boy who presented with repeated massive UGIB due to a left CCA pseudoaneurysm that was successfully managed multidisciplinarily. BB ingestion should be considered in toddlers presenting with hematemesis.
Original Article
Neonatology (Perinatology)
Evaluation of total serum bilirubin thresholds for discontinuing phototherapy in jaundiced neonates: a randomized study   (53 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.
Review Article
Endocrinology
A review of vitamin D deficiency and vitamin D receptor polymorphisms in endocrine-related disorders   (52 times)
Nur Faten Hafizah Rosli, Noor Shafina Mohd Nor, Rose Adzrianee Adnan, Siti Hamimah Sheikh Abdul Kadir
Clin Exp Pediatr. 2025;68(1):30-52.   Published online November 6, 2024
· The prevalence of vitamin D deficiency is high among children and adolescents and mainly attributed to changes in environmental factors.
· Vitamin D hormone-like properties are associated with many endocrine-related disorders.
· The effect of vitamin D is modulated by the vitamin D receptor, polymorphisms of which are reportedly associated with an increased risk of disease development in children and adolescents.
Editorial
Other
Further research on impact of microplastics on children's health is essential to protecting future generations   (52 times)
Jongin Lee, Dong-Wook Lee
Clin Exp Pediatr. 2025;68(5):359-361.   Published online November 13, 2024
· The ecological impacts of microplastics have been documented. It was recently recognized that they can directly or indirectly cause diseases in humans.
· There are few established methods for assessing human exposure to microplastics.
· Standardization of exposure assessments and large-scale epidemiological studies are required to explore the human effects of microplastics.
Allergy
Comorbidities of allergic rhinitis in children   (51 times)
Yong Ju Lee
Clin Exp Pediatr. 2024;67(12):675-676.   Published online July 31, 2024
· Allergic rhinitis in children often goes undiagnosed or untreated, with significant systemic complications like sleep disorders, growth issues, and gastrointestinal symptoms linked to nasal obstruction.
· A patient-centered action plan that considers symptom severity, preferences, and comprehensive management of associated complications is essential for effective treatment.
Original Article
General Pediatrics
The role of serum zinc and selenium levels in etiology of febrile seizures   (51 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.
Editorial
Endocrinology
Rickets prevalence and treatment outcome: real-world data from Taiwan   (51 times)
Young Suk Shim
Clin Exp Pediatr. 2025;68(11):868-870.   Published online October 23, 2025
Rickets should be recognized as a significant public health concern during infancy and childhood. Recent studies from Taiwan have demonstrated a steady increase in the prevalence of nutritional rickets, and a similar trend is likely to emerge in Korea. Therefore, comprehensive clinical evaluation and appropriate biochemical assessment are essential to prevent long-term skeletal and systemic complications. Prompt diagnosis and timely initiation of appropriate treatment are crucial.
Review Article
Adolescence Medicine
Diet-related behaviors affecting health and substance use among children and adolescents   (50 times)
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.
Other
Cost-effectiveness of newborn screening for severe combined immunodeficiency: a systematic review   (49 times)
Rezwanul Rana, Syed Afroz Keramat, Moin Ahmed
Clin Exp Pediatr. 2025;68(9):628-640.   Published online April 16, 2025
Universal newborn screening for severe combined immunodeficiency (SCID) demonstrates robust cost-effectiveness across diverse high-income healthcare systems, both from healthcare and societal standpoints. Early detection yields substantial savings. While uncertainties persist, impacting precise cost-effectiveness, the overall finding is positive. Future research must prioritize enhanced data collection and statistical rigor to refine our understanding of SCID's economic impact within the Australian context.
Editorial
Neurology
Tocilizumab as a key therapeutic option in high-risk pediatric acute necrotizing encephalopathy   (49 times)
Jon Soo Kim
Clin Exp Pediatr. 2026;69(2):114-116.   Published online January 26, 2026
· Acute necrotizing encephalopathy (ANE) is a severe, infection- triggered encephalitis driven primarily by cytokine- mediated immune dysregulation rather than direct viral cytotoxicity.
· Tocilizumab, through targeted inhibition of interleukin-6 signaling, is an important therapeutic option for ANE that may improve survival and neurological outcomes of high-risk pediatric patients.
Original Article
Neonatology (Perinatology)
Thrombocytopenia in preterm infants born to mothers with systemic lupus erythematosus: a retrospective cohort study   (48 times)
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.
Critical Care Medicine
Cytokine profile of Post–cardiopulmonary bypass in children   (47 times)
Kantara Saelim, Kanokpan Ruangnapa, Jirayut Jarutach, Pongsanae Duangpakdee, Smonrapat Surasombatpattana, Pharsai prasertsan
Clin Exp Pediatr. 2025;68(12):1015-1022.   Published online September 19, 2025
Question: Can cytokine levels predict low cardiac output syndrome (LCOS) in children post–cardiopulmonary bypass?
Finding: Elevated interleukin (IL)-6, IL-8, and tumor necrosis factor-α levels were associated with LCOS, with an increase in IL-8 of >56 pg/mL from baseline to immediately postoperative being the strongest predictor.
Meaning: Monitoring immediately postoperative IL-8 levels may help identify pediatric patients at risk of LCOS, enabling timely interventions to improve outcomes.
Review Article
Gastroenterology
Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children   (47 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.
Original Article
Oncology
HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol   (47 times)
Parisa Maneechai, Cholada Ratanatharathron, Jassada Buaboonam, Kleebsabai Sanpakit
Clin Exp Pediatr. 2025;68(12):974-980.   Published online October 2, 2025
Question: Does human leukocyte antigen (HLA)–B*58:01 increase the risk of cutaneous reactions in pediatric patients with hematological and oncological diseases receiving allopurinol?
Finding: : Of 108 patients, 17.6% carried HLA–B*58:01 but none developed skin reactions. The only rash occurred in an HLA-B*58:01–negative patient.
Meaning: Short-duration allopurinol may mitigate severe cutaneous adverse reaction risk regardless of genotype. Routine HLA-B*58:01 screening may be unnecessary in pediatric patients with hematological and oncological diseases briefly receiving allopurinol.
Perspective
General Pediatrics
Parenting principles to combat attention-deficit/hyperactivity disorder and form resilient young minds   (46 times)
Jandy Le, Sandhya J. Kadam
Clin Exp Pediatr. 2025;68(10):838-841.   Published online September 22, 2025
The prevalence of attention-deficit/hyperactivity disorder, conduct disorder, and other related behavioral problems is increasing among children, likely due to less interaction with their parents and the real world and more time spent on screens, on social media, and in the virtual world. This article highlights several simple, basic parenting principles to facilitate the growth of healthy, resilient minds and combat the symptoms of opposition, hyperactivity, and distractibility.
Original Article
Gastroenterology
Fecal microbiome profiles in infants with biliary atresia versus nonbiliary atresia cholestasis: a pilot study   (46 times)
Nur Azizah, Fadilah Fadilah, Silvia Werdhy Lestari, Muzal Kadim, Fithriyah Sjatha, Hanifah Oswari
Clin Exp Pediatr. 2025;68(11):932-943.   Published online August 20, 2025
Question: How does the gut microbiota profile of infants with biliary atresia (BA) differ from that of infants with non-BA cholestasis and healthy infants in the Indonesian population?
Finding: The unique fecal microbiome composition of the BA group differed significantly from that of the other 2 groups.
Meaning: There is an urgent need to improve dysbiosis in BA and non-BA cholestasis to prevent worsening liver injury in cholestasis.
General Pediatrics
Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia   (45 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.
Clinical Note
General Pediatrics
Aplasia cutis congenita with unique vascular malformation and cranial hypoplasia: a case in a preterm infant   (45 times)
Yasufumi Sakata, Natsumi Fujii, Sadahiro Nomura, Yoshihiro Azuma, Hiroki Hamano, Hidenobu Kaneyasu, Seigo Okada, Kazumasa Takahashi, Shunji Hasegawa
Clin Exp Pediatr. 2025;68(6):472-474.   Published online March 11, 2025
Original Article
Cardiology
Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea   (45 times)
Soo In Jeong, GI Beom Kim, Sung Hye Kim, Jae Yoon Na, Hong Ju Shin, Sin Weon Yun, Lucy Youngmin Eun, Sang Yun Lee, Chang-Ha Lee, Kwang Ho Choi, Seul Gi Cha, Mi Young Han
Clin Exp Pediatr. 2025;68(9):732-741.   Published online August 6, 2025
Question: What are the key challenges affecting pediatric cardiologists and cardiac surgeons in Korea?
Finding: Excessive workloads, low procedural volumes, and legal risks contribute to high burnout. Regional disparities limit skill maintenance and threaten workforce sustainability.
Meaning: Targeted policies ensuring fair workloads, legal protections, and regional support are essential to stabilizing the pediatric cardiac workforce and maintaining high-quality care.
Other
Balance assessment with decreased base of support for children with disabilities   (44 times)
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.
Editorial
Hematology
Absolute versus functional iron deficiency   (44 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.
Original Article
Cardiology
Influence of atrial septal defect on mitral valve growth after repair of coarctation of the aorta or an interrupted aortic arch in infants   (44 times)
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.
Nutrition
Energy drink consumption among Korean adolescents: prevalence and associated factors   (43 times)
Jee-Seon Shim, Jeong Mi Lee
Clin Exp Pediatr. 2024;67(10):531-539.   Published online September 24, 2024
Question: How prevalent is energy drink consumption among Korean adolescents and what are the associated factors?
Findings: The prevalence of energy drink consumption among Korean adolescents increased from 3.2% in 2014 to 12.2% in 2019. Energy drink consumption varies according to sociode-mographic and individual factors.
Meaning: Policies and educational strategies are needed to reduce energy drink consumption in adolescents.
Editorial
Allergy
Prioritizing maternal sleep: a public health strategy for preventing childhood allergic diseases   (43 times)
Eunchae Lee, Seohyun Hong, Dong Keon Yon
Clin Exp Pediatr. 2026;69(1):22-25.   Published online December 18, 2025
Sleep disorders affect more than half of pregnancies worldwide and can harm maternal health and offspring outcomes. Prioritizing maternal sleep as a public health strategy may help prevent prenatal and pediatric allergic diseases and reduce their burden. Other maternal health strategies may also reduce the burden of offspring allergic diseases, while adequate maternal sleep is associated with other offspring outcomes, underscoring its importance as a key public health strategy.
General Pediatrics
Adiposity rebound in early childhood: understanding body mass index percentiles and monitoring on growth charts to be healthy   (43 times)
Sochung Chung
Clin Exp Pediatr. 2026;69(4):301-303.   Published online April 1, 2026
Height, weight, and body mass index percentiles should be tracked in routine childhood health checkups to address the age of adiposity rebound in early childhood. Comprehensive interventional lifestyle counselling in primary practice after growth and nutritional status assessments might be an early, effective strategy for preventing obesity and decreasing the double burden of disease in later life. Therefore, there is an urgent need for a cooperative and supportive health care system.


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