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

Review Article
Hematology
Iron deficiency in children with a focus on inflammatory conditions   (32 times)
Na Hee Lee
Clin Exp Pediatr. 2024;67(6):283-293.   Published online May 21, 2024
· Iron deficiency has important effects on neurodevelopment and the immune system in children.
· Hepcidine plays an important role in iron homeostasis.
· Diagnosis and treatment of iron deficiency in chronic inflammatory disease are important for patients' quality of life and disease course.
Editorial
Cardiology
What we should know about pediatric heart failure: children are not small adults   (32 times)
Ja-Kyoung Yoon
Clin Exp Pediatr. 2025;68(1):62-64.   Published online November 6, 2024
· Pediatric heart failure (PHF) features high morbidity and mortality rates.
· Although adults and children can share a common diagnosis of heart failure, the underlying causes can differ significantly and require distinct therapeutic approaches.
· Treatments designed for adults are often applied to PHF despite the fundamental physiological and developmental differences between them.
· Child-specific data are vital for the development of tailored treatments to meet the unique needs of patients with PHF.
Review Article
Rheumatology
Double-negative T cells in pediatric rheumatic diseases   (31 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
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.
Original Article
Neonatology (Perinatology)
A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants   (30 times)
Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun
Clin Exp Pediatr. 2023;66(1):32-37.   Published online December 15, 2022
Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.
Endocrinology
Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency   (30 times)
Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul
Clin Exp Pediatr. 2025;68(3):238-246.   Published online November 13, 2024
Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population?
Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change.
Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development.
Clinical Note
Gastroenterology
Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation   (30 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
Original Article
Gastroenterology
Somatic symptom severity during acute illnesses among children with functional gastrointestinal disorders   (30 times)
Rattanachart Sirinil, Anundorn Wongteerasut
Clin Exp Pediatr. 2025;68(8):587-593.   Published online March 11, 2025
Functional gastrointestinal disorders (FGIDs) are associated with various somatic symptoms measured using a visual analogue scale and the Children’s Somatic Symptoms Inventory-24 questionnaire. Children with FGIDs exhibited more significant somatic symptoms than controls during acute illnesses. Gastrointestinal (GI) and non-GI manifestations are significantly more common in children with FGIDs.
Neurology
Instability of revised Korean Developmental Screening Test classification in first year of life   (30 times)
Ji Eun Jeong, You Min Kim, Na Won Lee, Gyeong Nam Kim, Jisuk Bae, Jin Kyung Kim
Clin Exp Pediatr. 2025;68(1):97-103.   Published online November 11, 2024
Question: How stable are the revised Korean Developmental Screening Test score classifications in early infancy?
Finding: A significant number of infants improved into the peer and high-level group (≥-1 standard deviations), especially in the gross motor area.
Meaning: The early detection of developmental delay requires a comprehensive medical history, physical and neurological examinations, and repeated developmental screenings.
Neonatology (Perinatology)
Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial   (29 times)
Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi
Clin Exp Pediatr. 2024;67(5):249-256.   Published online March 26, 2024
Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia?
Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants.
Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay.
Other
Balance assessment with decreased base of support for children with disabilities   (29 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
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
Other
Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea   (28 times)
Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S. Tremblay
Clin Exp Pediatr. 2025;68(1):16-29.   Published online November 11, 2024
· The 24-hour movement behavior paradigm provides an important framework for future pediatric health promotion efforts.
· Policy priorities should include advancing surveillance and monitoring assessments related to 24-hour movement behaviors, evaluating their implementation in school and government policies, and building preparedness for future pandemics and natural disasters, including climate change, by promoting healthy 24-hour movement behaviors.
· Future research should advocate for the promotion of 24- hour movement behaviors.
Editorial
General Pediatrics
Global breastfeeding efforts: a long way to go   (28 times)
Hye-Jung Shin
Clin Exp Pediatr. 2025;68(4):300-302.   Published online November 13, 2024
· Despite much effort, breastfeeding practices remain unsatisfactory worldwide.
· Effective breastfeeding-promoting interventions are needed that are appropriate for age, culture, and social environment.
· Interventions can promote breastfeeding, especially in younger populations such as adolescent mothers.
Nephrology (Genitourinary)
Optimal hemodialysis treatment for pediatric kidney failure patients   (27 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
Recent topics on gastrointestinal allergic disorders   (27 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
Developmental and Behavioral Medicine
Impact of short and intensive art-based intervention on symptomatology and social interactions among children with autism spectrum disorder   (27 times)
Deldar Morad Abdulah, Bayar Mohammed Omar Abdulla, Pranee Liamputtong
Clin Exp Pediatr. 2023;66(10):447-454.   Published online September 14, 2023
Question: Does a short and intensive art-based intervention affect symptoms and social interactions among children with autism spectrum disorder (ASD)?
Finding: The short and intensive art-based intervention did not affect symptoms in children with ASD level 2 or 3, including social awareness, social cognition, social communication, social motivation, and autistic mannerisms.
Meaning: The short and intensive art-based intervention did not improve the symptoms of patients with ASD.
Editorial
Immunology
Utility of eosinophil granule proteins in management of pediatric chronic cough   (27 times)
Chang-Keun Kim
Clin Exp Pediatr. 2024;67(10):519-520.   Published online April 17, 2024
· Pediatric chronic cough often involves eosinophilic inflammation; however, objective measurements are not routinely used in treatment decisions.
· Accurate biomarkers of eosinophil activity, such as eosinophil-derived neurotoxin (EDN) and cationic proteins (ECP), should be used. EDN, which overcomes the shortcomings of ECP, recently received approval for use in Korean healthcare settings.
· EDN and ECP can play a role in treatment period and drug selection decisions.
Endocrinology
Nonalcoholic fatty liver disease in children and adolescents   (27 times)
Hae Sang Lee
Clin Exp Pediatr. 2024;67(2):90-91.   Published online January 24, 2024
· With the increase in childhood obesity, nonalcoholic fatty liver disease (NAFLD) has become a concern in recent years.
· NAFLD is strongly associated with insulin resistance.
· Lifestyle modifications are the mainstay treatment for NAFLD.
Original Article
Cardiology
Unsustainable and overworked: unpacking the challenges faced by pediatric cardiologists and cardiac surgeons in Korea   (27 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.
General Pediatrics
Virtual reality for pain reduction during intravenous injection in pediatrics: a systematic review and meta-analysis of controlled clinical trials   (26 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.
Clinical Note
Immunology
Comparative analysis of rare periodic fever syndromes including the first Korean case of hyperimmunoglobulinemia D and periodic fever syndrome   (26 times)
Yoonsun Yoon, Hyun Seo Kim, Jung Ok Shim, JungHwa Lee
Clin Exp Pediatr. 2024;67(10):550-552.   Published online September 24, 2024
Review Article
Immunology
Systemic autoinflammatory disorders   (25 times)
Dae Chul Jeong
Clin Exp Pediatr. 2023;66(10):432-438.   Published online June 14, 2023
· Systemic autoinflammatory disorders (SAID) are disorders caused by dysregulation of the innate immunity with genetic background, leading to recurrent episodes of systemic inflammation.
· SAID is characterized by recurrent acute inflammatory responses including fever or skin manifestations, unrelated with infection or malignancy.
· Diagnosis is based on family and long-term history with detailed clinical and laboratory manifestations during febrile periods.
Original Article
Neurobehavior
Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis   (25 times)
Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei
Clin Exp Pediatr. 2023;66(2):70-75.   Published online August 17, 2022
Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I2=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.
Pulmonology
Oligohydramnios affects pulmonary functional/structural abnormalities in school-aged children with bronchopulmonary dysplasia   (25 times)
Jeong Eun Shin, Soon Min Lee, Mi-Jung Lee, Jungho Han, Joohee Lim, Haerin Jang, Ho Seon Eun, Min Soo Park, Soo Yeon Kim, Myung Hyun Sohn, Ji Ye Jung, Kyung Won Kim
Clin Exp Pediatr. 2024;67(5):257-266.   Published online April 16, 2024
Question: Is bronchopulmonary dysplasia (BPD) associated with functional/structural abnormalities later in life?
Finding: School-aged children with severe BPD had abnormalities on pulmonary function tests and lung computed tomography despite no subjective respiratory symptoms; however, only prenatal oligohydramnios and prolonged ventilator use were associated with abnormal lung function.
Meaning: Long-term monitoring of preterm infants’ lung health is essential, especially for those with prenatal oligohydramnios or prolonged ventilator use.
Endocrinology
Kisspeptin and DLK1 levels for monitoring treatment of girls with central precocious puberty   (25 times)
Witchuwan Onsoi, Nattakarn Numsriskulrat, Suphab Aroonparkmongkol, Vichit Supornsilchai, Khomsak Srilanchakon
Clin Exp Pediatr. 2024;67(6):296-302.   Published online May 21, 2024
Questions: Can the serum levels of kisspeptin and DLK1 be potential biomarkers for monitoring the treatments for central precocious puberty (CPP)?
Findings: There were no significant differences in the baseline serum kisspeptin and DLK1 levels in CPP girls compared to girls with premature thelarche (PT). After 6 months of GnRH analogue treatment in CPP girls, median serum kisspeptin levels decreased, while median serum DLK1 levels increased compared to baseline.
Meanings: Serum levels of kisspeptin and DLK1 may serve as novel biomarkers for monitoring the efficacy of treatments for CPP.
Infection
Clinical, biochemical, and genetic study of TACE/TNF-α/ACE signaling pathway in pediatric COVID-19 infection   (25 times)
Ahmed El-Abd Ahmed, Sawsan M.A. Abuhamdah, Mohammed H. Hassan, Nagwan I. Rashwan, Eman A. Abd-Elmawgood, Haggagy Mansour, Hoda S. Sherkawy, Shymaa G. Rizk
Clin Exp Pediatr. 2024;67(12):704-717.   Published online November 27, 2024
Question: Is the tumor necrosis factor (TNF) signaling pathway (TNF-α-converting enzyme [TACE]/TNF-α/angiotensin converting enzyme [ACE]) involved in pediatric coronavirus disease 2019 (COVID-19) infection?
Finding: Significantly increased circulating TACE/TNF-α and decreased ACE2 levels were noted. TNF-α-308G/A plays a significant role in susceptibility to COVID-19 infection among children. The ACE (I/D) (rs4646994) and ACE2 (rs2285666) single nucleotide polymorphisms lack significant associations with pediatric COVID-19 infection.
Meaning: The TNF signaling pathway participates in pediatric COVID-19 infection.
Review Article
Gastroenterology
High-resolution esophageal manometry in children   (24 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.
Original Article
Neurology
Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review   (24 times)
Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga
Clin Exp Pediatr. 2023;66(1):38-45.   Published online November 30, 2022
· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.
Gastroenterology
Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome   (24 times)
Ozlem Kara, Hanife Aysegul Arsoy, Murat Keskin
Clin Exp Pediatr. 2023;66(9):395-402.   Published online June 14, 2023
Question: Is polycystic ovary syndrome (PCOS) a risk factor for nonalcoholic fatty liver disease (NAFLD) in adolescents?
Finding: The frequency of NAFLD did not increase in adolescents with PCOS. However, hyperandrogenemia was a risk factor for NAFLD.
Meaning: Adolescents with PCOS and hyperandrogenemia should be closely monitored for hepatic steatosis.
Basic Research
Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement   (24 times)
Moein Ghasemi, Abolfazl Basiri, Houman Kazemzadeh, Mohammad Amin Manavi, Seyed Mohammad Tavangar, Ahmad Reza Dehpour, Hamed Shafaroodi
Clin Exp Pediatr. 2025;68(9):700-711.   Published online August 26, 2025
Question: What pharmacological strategies can limit ischemia-reperfusion injury in pediatric patients with testicular torsion?
Finding: In a rat model of testicular torsion, linezolid reduced oxidative stress, inflammation, and tissue injury via the Toll-like receptor 4/mitogen-activated protein kinase/nuclear factor kappa beta pathway.
Meaning: Linezolid may offer a pharmacological approach to attenuate testicular damage in pediatric patients with testicular torsion, warranting further clinical investigation.


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