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

Editorial
Pulmonology
Wheezing in infants and preschoolers: phenotypes and treatment options   (28 times)
Jung Yeon Shim
Clin Exp Pediatr. 2023;66(1):26-27.   Published online December 6, 2022
· Knowing who will develop into asthma or who will not is important to impose proper treatment and early intervention in a child with the first episode of wheezing.
· Phenotypes of severe bronchiolitis in less than 2-year-old children with first episode of wheezing were suggested for different treatment options
· RV-induced and/or atopy-associated severe wheezing in preschool children may benefit from early intervention of asthma treatment.
Review Article
Pulmonology
Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies   (28 times)
Eun Kyo Ha, Ju Hee Kim, Man Yong Han
Clin Exp Pediatr. 2023;66(11):465-474.   Published online June 19, 2023
· Current definitions of long coronavirus disease (COVID) in children and adolescents vary in duration, ranging from 4 to 12 weeks or more.
· The clinical spectrum of long COVID in children and adolescents comprises a wide range of symptoms and might be a multisystem disorder.
· Persistent health problems with a prevalence of 1%–66.5% were reported in children and adolescents after COVID-19, with a higher incidence of persistent single or multiple symptoms.
Neonatology (Perinatology)
Influence of infant microbiome on health and development   (28 times)
Noelle Younge
Clin Exp Pediatr. 2024;67(5):224-231.   Published online August 21, 2023
· The infant gut microbiome is highly dynamic and individualized.
· Microbes are vertically transmitted from mother to infant during delivery and throughout infancy.
· Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function.
· In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems.
· Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality.
Original Article
Adolescence Medicine
Relationship between inflammatory biomarkers and insulin resistance in excess-weight Latin children   (28 times)
Mariano Nicolás Aleman, María Constanza Luciardi, Emilce Romina Albornoz, María Cristina Bazán, Adela Victoria Abregú
Clin Exp Pediatr. 2024;67(1):37-45.   Published online December 21, 2023
Question: What is the prevalence of insulin resistance (IR) in excess-weight Latin children, and can proinflammatory biomarkers predict it?
Finding: IR prevalence was elevated and tumor necrosis factor- α, interleukin-6, monocyte chemoattractant protein- 1, soluble CD40 ligand, and high-sensitivity C-reactive protein levels were increased in excess-weight Latin children. However, none predicted IR status.
Meaning: These inflammatory biomarkers were unable to predict IR status. Therefore, further investigations are necessary.
Editorial
Allergy
Trends in food allergen immunotherapy in Korea after changed national regulations   (27 times)
Tae Won Song
Clin Exp Pediatr. 2024;67(4):201-202.   Published online November 21, 2023
National regulations, academic guidelines, and clinical trends in food allergen immunotherapies (FA-AIT) differ among countries and have changed rapidly. Current officially approved FA-AIT are oral immunotherapy (OIT) using heated milk/egg in Korea and peanut OIT using standardized products in the United States and Europe. FA-AIT should be administered by specialist physicians with experience administering oral food challenge tests and managing severe allergic reactions inside and outside research settings.
Letter to the Editor
Pulmonology
Metabolic syndrome and pulmonary dysfunction in asthmatic children during the COVID-19 pandemic   (27 times)
Jue Seong Lee, Sang Hyun Park, Yoon Lee, Seunghyun Kim, Wonsuck Yoon, Young Yoo
Clin Exp Pediatr. 2024;67(3):168-170.   Published online February 19, 2024
Editorial
Nephrology (Genitourinary)
Optimal hemodialysis treatment for pediatric kidney failure patients   (26 times)
Yo Han Ahn
Clin Exp Pediatr. 2023;66(3):125-126.   Published online February 15, 2023
· Although the basic concept of hemodialysis (HD) is similar in adults and children, specific factors must be considered in the latter, including the small dialyzer and circuit, difficult vascular access, and frequent complications.
· HD-associated complications include catheter-related problems, hemodynamic instability, and neurodevelopmental and cognitive dysfunction.
· Pediatric HD is challenging, and steady efforts are needed to perform it safely and reduce its complications, thereby improving clinical outcomes.
Review Article
Allergy
Moderate to severe atopic dermatitis in children: focus on systemic Th2 cytokine receptor antagonists and Janus kinase inhibitors   (26 times)
Jeong Hee Kim, Mona Salem Samra
Clin Exp Pediatr. 2024;67(2):64-79.   Published online June 14, 2023
· Atopic dermatitis (AD) is characterized by a strong T helper (Th)2 response, although the extents of Th22, Th17/ interleukin (IL)-23, and Th1 responses vary among disease subtypes.
· Children with moderate to severe AD may require early systemic therapy to reduce the systemic inflammation caused by increased Th2 cytokine levels.
· Dupilumab, which blocks IL-4/IL-13 receptor, has equivalent efficacy for extrinsic and intrinsic AD and a favorable safety profile in infants and children aged 6 months and older.
Original Article
Developmental and Behavioral Medicine
Effectiveness of online responsive teaching in young children with developmental disabilities: a pilot study   (26 times)
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.
Review Article
Allergy
Trends of vitamin D in asthma in the pediatric population for two decades: a systematic review   (25 times)
Myongsoon Sung
Clin Exp Pediatr. 2023;66(8):339-347.   Published online June 14, 2023
· Vitamin D may affect asthma via multiple mechanisms, including lung and optimal immune system functions.
· Many clinical trials have demonstrated the beneficial effects of vitamin D on asthma onset and aggravation. However, definitive clinical trials are lacking, and reports have detailed contradictory effects of vitamin D in children with asthma.
· Some exciting reports stated that obesity and vitamin D deficiency are associated with increased asthma symptoms in the pediatric population.
Nutrition
Macronutrients modified dietary intervention in the management of overweight/obese children and adolescents: a systematic review   (25 times)
Jihyun Park, Oh Yoen Kim
Clin Exp Pediatr. 2024;67(4):191-200.   Published online July 11, 2023
· Dietary macronutrient modifications affect the body composition of and metabolic markers in children and adolescents.
· Hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children.
· Future interventional studies with meta-analyses that include Korean children and adolescents are needed to provide basic information applicable to this population.
Infection
COVID-19 among infants: key clinical features and remaining controversies   (25 times)
Nevio Cimolai
Clin Exp Pediatr. 2024;67(1):1-16.   Published online November 27, 2023
· Clinical studies of coronavirus disease 2019 (COVID-19) in infants should be supported by rigorous laboratory diagnostic criteria.
· Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads to infants similarly to other viral respiratory infections.
· Among infants ≤1 year of age beyond the immediate postpartum period, COVID-19 is relatively mild, but even the low risk of severe disease requires prevention.
· Comorbidities increase infection vulnerability and complications in infants.
· Clinical and laboratory data do not sufficiently distinguish COVID-19 from other respiratory viral infections.
· Coinfection with SARS-CoV-2 is uncommon among infants.
· Unique infection sequelae, including multi-inflammatory syndrome in children and neonates and long COVID require further study and refinement of diagnostic criteria.
· Infection control standards applied to mother-infant dyads should be tempered by standard preventive strategies, maternal input, accommodation potential, and overall safety.
· Maternal vaccination prevents disease in early infancy.
Editorial
Pulmonology
Community-acquired pneumonia in Korean children: time to read between the lines   (24 times)
Dong In Suh
Clin Exp Pediatr. 2023;66(1):22-23.   Published online November 10, 2022
· Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children
· Factors other than etiology are equally important to a compre hensive understanding of CAP
· Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification
Review Article
Allergy
Recent topics on gastrointestinal allergic disorders   (24 times)
Yoshiyuki Yamada
Clin Exp Pediatr. 2023;66(6):240-249.   Published online January 9, 2023
Gastrointestinal (GI) allergies are divided into immunoglobulin E (IgE)-mediated, non-IgE-mediated, and mixed types. In addition to non-IgE-mediated, overlapping eosinophilic GI disorders (EGIDs) have increased in Japan. EGIDs, a mixed-type allergy category, include eosinophilic esophagitis (EoE) and non-EoE EGIDs. The number of EoE cases has increased in Western countries, followed by Asian countries. Recent GI allergies may also be associated with type 2 inflammation.
Original Article
General Pediatrics
Virtual reality for pain reduction during intravenous injection in pediatrics: a systematic review and meta-analysis of controlled clinical trials   (24 times)
Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Masoud Rafiee, Mozhdeh Bashirian
Clin Exp Pediatr. 2023;66(12):533-537.   Published online June 14, 2023
Question: This is the first meta-analysis to examine published evidence of the effectiveness of virtual reality at reducing pain during pediatric intravenous injections.
Finding: Our results suggest that virtual reality effectively reduces pain associated with intravenous injections in pediatric patients.
Meaning: These findings suggest the importance of virtual reality in decreasing the pain of intravenous injections among children.
Developmental and Behavioral Medicine
Neonatal risk factors associated with attention-deficit/hyperactivity disorder: an umbrella review   (24 times)
Ensiyeh Jenabi, Erfan Ayubi, Sajjad Farashi, Saeid Bashirian, Fereshteh Mehri
Clin Exp Pediatr. 2023;66(10):441-446.   Published online July 14, 2023
Question: The risk factors for attention deficit hyperactivity disorder (ADHD), such as breastfeeding, congenital heart disease, and low birth weight, in neonates are not well understood.
Finding: This umbrella review obtained significant effect sizes for ADHD for congenital heart disease (odds ratio [OR], 3.04), low birth weight (OR, 2.25), never breastfed (OR, 1.55), and Apgar score (OR, 1.30).
Meaning: Congenital heart disease, low birth weight, lack of breastfeeding, and Apgar scores were significant factors for ADHD.
Attention-deficit/hyperactive-impulsive disorder symptoms among grade 1 students with reading disorder in Thailand   (24 times)
Patcharapun Sarisuta, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho
Clin Exp Pediatr. 2023;66(11):485-492.   Published online October 24, 2023
Question: Would students with reading disorder have a significantly higher prevalence of attention-deficit/hyperactiveimpulsive disorder (ADHD) symptoms than neurotypical students?
Finding: Students at risk of reading disorder exhibited significant ADHD symptoms compared with those not at risk of reading disorder according to all presentations of teacher assessments versus only for predominantly inattentive presentations of the parental assessments.
Meaning: Students with reading disorder have a significantly higher prevalence of ADHD symptoms than neurotypical students. Sex, parental education level, average family income, and children’s school affiliation significantly influenced reading disorder prevalence.
Letter to the Editor
Developmental and Behavioral Medicine
Efficacy of social skills group intervention among children with mild autism spectrum disorder   (24 times)
Lee Ling Low, Ker Yang Chua, Bih Hwa Ching
Clin Exp Pediatr. 2024;67(7):368-370.   Published online May 31, 2024
Review Article
Gastroenterology
Role of social media use in onset of functional gastrointestinal disorders in children   (23 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.
Nephrology (Genitourinary)
Kidney complications associated with COVID-19 infection and vaccination in children and adolescents: a brief review   (23 times)
Hee Sun Baek, Min Hyun Cho
Clin Exp Pediatr. 2023;66(10):424-431.   Published online June 28, 2023
Several observational studies have shown that acute kidney injury affects up to 46% of children and adolescents who develop severe postinflammatory responses, such as multisystem inflammatory syndrome in childhood, due to coronavirus disease 2019 (COVID-19). Although causality has not been established, some cases of glomerulopathy or nephrotic syndrome occurring after COVID-19 infection or vaccination have been reported. Therefore, kidney complications associated with these conditions in children and adolescents warrant attention.
Original Article
Gastroenterology
Inferior vena cava to aorta ratio in dehydrated pediatric patients: a systematic review and meta-analysis   (22 times)
Gilbert Sterling Octavius, Michelle Imanuelly, Johan Wibowo, Nadia Khoirunnisa Heryadi, Melanie Widjaja
Clin Exp Pediatr. 2023;66(11):477-484.   Published online June 14, 2023
Question: The inferior vena cava to aorta (IVC/Ao) ratio measured via ultrasound has been touted as a promising noninvasive technique to assess clinically significant dehydration in pediatric patients.
Finding: Our meta-analysis found that IVC/Ao ratio had a positive likelihood ratio of 3.2 (95% confidence interval [CI], 2.1–5.1) and negative likelihood ratio of 0.18 (95% CI, 0.12–0.28).
Meaning: Hence, IVC/Ao ratio is insufficient to exclude or confirm significant dehydration in pediatric patients.
Clinical Note
Neurology
Expanding association between BICD2 variants and brain malformations and associated lissencephaly   (22 times)
Jaeso Cho, Haeryung Kim, Seoungbok Lee, Jihoon G Yoon, HyeJin Kim, Minhye Kim, Seoyun Jang, Woojoong Kim, Soo Yeon Kim, Jong Hee Chae
Clin Exp Pediatr. 2024;67(1):54-56.   Published online December 21, 2023
Original Article
Neurology
Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study   (22 times)
Hyejin Na, Sanghoon Lee, Seo Hee Kim, Young Ok Kim
Clin Exp Pediatr. 2024;67(4):213-220.   Published online March 19, 2024
Question: Did coronavirus disease 2019 (COVID-19) affect the frequency, seasonal variation, or virus type of benign convulsions with mild gastroenteritis (CwG)?
Findings: We compared 41 cases of CwG before and during the COVID-19 pandemic. After March 2020, frequency did not change significantly (18 patients vs. 23 patients), seasonal variation was lost, and number of cases of enteric adenovirus-associated CwG increased (1 cases vs. 7 cases).
Meaning: The COVID-19 pandemic affected CwG.
Genetics and Metabolism
Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis   (22 times)
Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee
Clin Exp Pediatr. 2025;68(3):257-265.   Published online November 28, 2024
Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function?
Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk.
Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal.
Developmental and Behavioral Medicine
Parenting stress and interactive engagement behaviors in children with developmental delay   (21 times)
Jung Sook Yeom, Rock Bum Kim, Jae Young Cho, Ji Sook Park, Eun Sil Park, Ji-Hyun Seo, Jae-Young Lim, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(6):252-261.   Published online May 19, 2023
· Question: What level of parenting stress is experienced by parents of children with developmental delays (DDs) without autism spectrum disorder, and what factors contribute to it?
· Findings: Parents of children with DDs experienced high parenting stress that were significantly mediated by their children’s low interactive behaviors.
· Meaning: The interactive behaviors of children with DDs mediate parenting stress.
Clinical Note
Gastroenterology
Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation   (21 times)
Upasana Ghosh, Ujjal Poddar, Srinivas Srinidhi Vadlapudi, Moinak Sen Sarma, Anshu Srivastava
Clin Exp Pediatr. 2025;68(3):266-268.   Published online January 13, 2025
Review Article
Gastroenterology
High-resolution esophageal manometry in children   (20 times)
Yogesh Waikar
Clin Exp Pediatr. 2023;66(4):155-160.   Published online October 17, 2022
High-resolution esophageal manometry can be safely performed in children where recurrent vomiting and persistent dysphagia is the working diagnosis after excluding nonluminal and structural obstructive pathologies using pediatric upper gastrointestinal endoscopy. Normal manometry values are available. Clinical picture, biochemical tests, radiological interpretation, and endoscopic findings with manometry completes the analysis of patients with recurrent vomiting and dysphagia.
Nutrition
Protein substitutions as new-generation pharmanutrition approach to managing phenylketonuria   (20 times)
Fatma Nur Keskin, Teslime Özge Şahin, Raffaele Capasso, Duygu Ağagündüz
Clin Exp Pediatr. 2023;66(8):320-331.   Published online November 1, 2022
Phenylketonuria, an autosomal recessive disease that results from the inability to metabolize phenylalanine, is currently treated with medical nutrition therapy. New treatment approaches such as tetrahydrobiopterin, glycomacropeptide, large neutral amino acids, pegvaliase, and gene therapy significantly impact disease management and dietary enrichment. This article also reviews animal and human studies that have evaluated the efficacy and safety of these new protein substitutes.
Editorial
Neonatology (Perinatology)
Impacts of maternal COVID-19 during pregnancy on neonatal health and epidemiology   (20 times)
Jae Woo Lim
Clin Exp Pediatr. 2024;67(3):149-151.   Published online December 28, 2023
Newborns born to mothers infected with coronavirus disease 2019 (COVID-19) should be closely monitored for respiratory disorders, such as transient tachypnea of the newborn, regardless of their COVID-19 test results. Further research is required of the development of infants born to mothers with COVID-19. The trends in Korea's birth rate and infant mortality rates have not been significantly affected by COVID-19.
Letter to the Editor
General Pediatrics
Vitamin B12 deficiency in anemic children before versus after age 2 years: a form of hidden hunger in India   (20 times)
Sahil Goel, Ruchika Bhatnagar, Anita Kumari, Brig Prem Lochan Prasad, Lahar Sahai
Clin Exp Pediatr. 2024;67(2):116-118.   Published online January 24, 2024


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