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

Original Article
Infection
Clinical outcomes and healthcare utilization of hospitalized children with influenza versus COVID-19   (32 times)
David Chun-Ern Ng, Chuin-Hen Liew, Kah Kee Tan, Joanne Pereira, Muhammad Ihsan Roslan, Xiang Lin Cheng, Hui Yi Lim, Farah Nuruliayana A. Nazri, Asuwani Maran, Wan Fei Wong, Yasothai Chandran, Syaniza Shaharudin, Pon Ling Lau, Naveen Nair Gangadaran, Marlindawati Mohd Ali
Clin Exp Pediatr. 2025;68(12):1007-1014.   Published online October 2, 2025
Question: How do clinical presentations, healthcare resource utilization, and outcomes differ between children hospitalized with influenza versus coronavirus disease 2019 (COVID-19)?
Finding: Patients with influenza were older, were more symptomatic, and required greater healthcare resources, including intravenous fluids, empirical antibiotics, respiratory support, and pediatric intensive care unit admission.
Meaning: Influenza involves greater severity and a higher healthcare burden than COVID-19, highlighting the need for preventive strategies such as vaccination and hospital resource planning during seasonal outbreaks.
Pulmonology
Ciclesonide shows a lung-protective effect in neonatal hyperoxia-exposed rats   (32 times)
Victoria Mielgo, Miguel A. Gomez-Solaetxe, Lara Olazar, Begoña Loureiro, Carmen Rey-Santano
Clin Exp Pediatr. 2025;68(12):1023-1030.   Published online October 2, 2025
Question: Bronchopulmonary dysplasia (BPD) is the most prevalent chronic lung disease of prematurity. Numerous nonpharmacological/pharmacological interventions have been investigated without clear consensus. Can ciclesonide, a new synthetic glucocorticoid, effectively treat BPD?
Finding: Ciclesonide mitigated hyperoxia-induced lung injury and right ventricular hypertrophy in newborn rats.
Meaning: These findings suggest that postnatal ciclesonide may be an alternative to existing corticosteroids for the treatment of BPD.
Perspective
General Pediatrics
Navigating the complex behavioral landscape of children in foster care and adopted families   (32 times)
Anisha Choi, Sandhya J. Kadam
Clin Exp Pediatr. 2025;68(8):620-623.   Published online May 12, 2025
Original Article
Neurology
Clinical application of whole exome and genome sequencing in pediatric neurodevelopmental disorders   (32 times)
Keun Soo Lee, Seung Hwan Oh, Ja Young Lee, Go Hun Seo, Da Eun Roh, Ji Kyoung Park, Bo Lyun Lee
Clin Exp Pediatr. 2026;69(5):417-427.   Published online April 22, 2026
Question: What is the diagnostic utility of whole exome sequencing (WES) and whole genome sequencing (WGS) in unexplained neurodevelopmental disorders (NDDs)?
Finding: WES and WGS achieved a combined diagnostic yield of 39.1% in children with NDDs. Novel variants accounted for over half the pathogenic findings, and trio-based or phenotype-driven testing improved the diagnostic rate.
Meaning: Comprehensive genomic sequencing integrated with clinical phenotyping enhances diagnostic yield among children with NDDs.
Review Article
Developmental and Behavioral Medicine
Effect of pesticide exposure on stunting incidence: a systematic review and meta-analysis   (31 times)
Sani Rachman Soleman, Yaltafit Abror Jeem, Muhammad Fathi Banna Al Faruqi, Mahdea Kasyiva, Vita Widyasari, Kuswati Kuswati, Nur Aini Djunet, Muflihah Rizkawati, Ety Sari Handayani
Clin Exp Pediatr. 2024;67(10):510-518.   Published online September 24, 2024
This review aimed to determine whether pesticide exposure is associated with stunting in children. The 13 included studies agree that pesticide exposure is not correlated with stunting incidence regardless of substance type (organophosphate and pyrethroid). Heterogeneity appeared with age covariate as potential confounding. The evidence of this study is challeng-ing, as the adverse effects of pesticides grossly occurred. The protection of children is warranted for preventing future neurodevelopment issues.
Original Article
Gastroenterology
Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study   (31 times)
Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw
Clin Exp Pediatr. 2025;68(3):247-256.   Published online November 13, 2024
Question: Short-term (1-year) follow-up data in pediatric patients with inflammatory bowel disease (IBD), especially in Southeast Asian countries, are limited.
Finding/Meaning: Abdominal pain and pallor rates remained high at 1 year after IBD diagnosis. Three independent factors of 1-year clinical remission for Crohn disease were oral prednisolone, antibiotic, and immunomodulator use at 1-year follow-up. A history of weight loss at diagnosis was the only independent risk factor of IBD flare.
Neonatology (Perinatology)
Incidence of neural tube defects in tertiary care university hospital in Bangladesh   (31 times)
Ismat Jahan, Arif Hossain, Shah Nizam Uddin Shaon, Sadeka Choudhury Moni, Mohammad Kamrul Hassan Shabuj, Sanjoy Kumer Dey, Mohammad Abdul Mannan, Mohammod Shahidullah
Clin Exp Pediatr. 2025;68(7):530-538.   Published online April 1, 2025
Question: What is the burden of neural tube defects (NTDs) in a tertiary care neonatal intensive care unit in Bangladesh?
Finding: The overall incidence of NTD was 6.4 (range, 4.59–11.2) per 1,000 live births, and the meningomyelocele complex was the most frequent location.
Meaning: The high incidence of NTD found in a leading tertiary care multidisciplinary referral hospital in Bangladesh may not reflect that of the wider population.
Other
Role of neutrophil elastase in predicting infection among children with chemotherapy-induced febrile neutropenia   (31 times)
Mahmoud A. El-Hawy, Doaa M. Elian, Mai El-Sayad Abd El-Hamid, Esraa T. Allam, Mariam S. Kandeel, Asmaa A. Mahmoud
Clin Exp Pediatr. 2025;68(10):801-807.   Published online June 10, 2025
Question: Can neutrophil elastase (NE) levels predict infection— the primary cause of mortality—among children with hematological malignancies and febrile neutropenia (FN)?
Finding: Elevated levels of NE were found in children with chemotherapy-induced FN and a bacterial infection.
Meaning: Increased NE levels and prolonged FN are important factors associated with mortality risk.
Critical Care Medicine
Telemedicine outcome of mechanically ventilated children in Brazilian pediatric intensive care units   (31 times)
Aristóteles de Almeida Pires, Luciano Remião Guerra, João Ronaldo Mafalda Krauzer, Luciane Gomes da Cunha, Mariana Motta Dias da Silva, Vanessa Cristina Jacovas, Hilda Maria Rodrigues Moleda Constant, Taís de Campos Moreira, Paulo Márcio Pitrez, Felipe Cezar Cabral
Clin Exp Pediatr. 2026;69(2):140-149.   Published online October 23, 2025
Question: Telemedicine interventions in Brazilian public pediatric intensive care units effectively address the challenges related to specialized care provision in resource-limited settings.
Finding: The implementation of telemedicine significantly reduced overall mortality rates among mechanically ventilated children (from 20.7% to 10.4%) and increased ventilator-free days from 3 (interquartile range, 0–7) to 4 (interquartile range, 2–8) days.
Meaning: These findings support telemedicine as a viable strategy for enhancing pediatric critical care in public health systems, particularly by improving patient outcomes.
Clinical Note
Genetics and Metabolism
Happle-Tinschert syndrome in an infant: clinical, radiologic and genetic correlation   (31 times)
Belén Rodríguez-Sanchez, Francisco Javier Narbona-Cárceles, Jorge Martín-Nieto-González, Marina de la Puente-Alonso, Luis Zamarro-Díaz, Luis Jiménez-Briones, Julia Suárez-González, Francisco Arias-Lotto, Minia Campos-Domínguez
Clin Exp Pediatr. 2026;69(2):182-185.   Published online January 20, 2026
Original Article
Neonatology (Perinatology)
Context-dependent features of transcriptomic landscapes in pregnant mother-neonate dyads of preeclampsia   (31 times)
Yu-Chun Cheng, Yun-Ju Lai, Wei-Shiung Lian, Ching-Chang Tsai, Hsin-Hsin Cheng, Hong-Ren Yu, Mao-Meng Tiao, Jiunn-Ming Sheen, Ying-Lun Hsu, Feng-Sheng Wang, I-Chun Lin
Clin Exp Pediatr. 2026;69(5):394-406.   Published online February 19, 2026
Question: What genes are commonly altered in mother-neonate dyads immediately after shared exposure to preeclampsia?
Finding: Perinatal/peripartum gene expression in preeclampsia is context-dependent, involves diverse signaling pathways, and is associated with some perinatal features.
Meaning: Our results may help build the fundamentals for managing future cardiometabolic risks in these populations. Further investigation of the long-term influence of these candidate genes on cardiometabolic phenotypes is required.
Neurology
Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study   (30 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.
Clinical Note
Gastroenterology
Abdominal pain in a young girl: a twist in the tale   (30 times)
Upasana Ghosh, Ankit Agrawal, Umesh Shukla, Vikas Jain, Deeksha Bhalla
Clin Exp Pediatr. 2025;68(5):395-397.   Published online March 11, 2025
· Chronic abdominal pain caused by a gastric trichobezoar is extremely rare among children.
· An indentable epigastric mass is characteristic and upper gastrointestinal endoscopy is diagnostic of a gastric trichobezoar.
· Symptomatic large trichobezoars usually require surgery.
· Neuropsychiatric disorders are often associated with gastric trichobezoar, making a psychiatric evaluation of paramount importance.
Genetics and Metabolism
Expanding genotype-phenotype correlation of Kenny-Caffey syndrome type 1   (30 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
Original Article
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.
Review Article
Nutrition
Macronutrients modified dietary intervention in the management of overweight/obese children and adolescents: a systematic review   (29 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.
Endocrinology
Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis   (29 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.
Original Article
Pulmonology
Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?   (29 times)
Rungrat Sukharom, Prakarn Tovichien, Kanokporn Udomittipong, Pinyapach Tiamduangtawan, Wattanachai Chotinaiwattarakul
Clin Exp Pediatr. 2025;68(1):80-90.   Published online November 6, 2024
Question: How Common is obstructive sleep apnea (OSA) in obese children? OSA is common in obese children, even without habitual snoring.
Finding: Among the subjects, 60.6% had positional OSA, 40.2% had rapid eye movement-related OSA, 59.8% had desaturation, 20.5% had sleep-related hypoventilation, and 5.0% had obesity hypoventilation syndrome. Body mass index (BMI) and neck and waist circumferences were significantly associated with severe OSA.
Meaning: We recommend screening obese children (BMI > 29.2 kg/m2) for OSA.
Endocrinology
Efficacy of leuprolide acetate versus triptorelin pamoate administered every 3 months for treatment of central precocious puberty   (29 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.
Review Article
General Pediatrics
Protecting our future: environmental hazards and children’s health in the face of environmental threats: a comprehensive overview   (28 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
· 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.
Allergy
Moderate to severe atopic dermatitis in children: focus on systemic Th2 cytokine receptor antagonists and Janus kinase inhibitors   (28 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
Neurology
Evaluation of pediatric migraine triggers: a single-center study   (28 times)
Hey-Joon Son, Joo-Ok Jin, Kon-Hee Lee
Clin Exp Pediatr. 2025;68(2):163-169.   Published online November 11, 2024
Question: What are the primary triggers for pediatric migraines, and how do they impact clinical management?
Finding: Common triggers for pediatric migraines include sleep disturbances, academic stress, and motion sickness, with academic stress identified as the most intense.
Meaning: Recognizing and addressing specific triggers like sleep disturbance and academic stress is crucial to effectively managing pediatric migraines with emphasis on personalized care to improve outcomes.
Gastroenterology
Treatment targeting pediatric inflammatory bowel disease-associated anemia: experience from a single tertiary center   (28 times)
Ana S.C. Fernandes, Sara Azevedo, Ana Rita Martins, Ana Isabel Lopes
Clin Exp Pediatr. 2025;68(9):722-731.   Published online June 10, 2025
Question: Does treating iron deficiency (ID) using intravenous iron in pediatric inflammatory bowel disease (IBD) feature long-term safety and efficacy?
Finding: Intravenous iron supplementation was safe and effective. However, the ID recurrence rate was higher than expected.
Meaning: Proactive screening and treatment of ID in pediatric IBD are essential. The Ganzoni formula likely underestimates the iron requirements of pediatric patients. Prospective trials are needed to optimize iron treatment dosing.
Neurology
Classification of neurocognitive impairment in pediatric drug-resistant focal epilepsy by quantifying seizure-affected brain network abnormalities in clinical diffusion-weighted imaging connectome   (28 times)
Jeong-Won Jeong, Min-Hee Lee, Yoon Ho Hwang, Michael Behen, Aimee Luat, Csaba Juhász, Eishi Asano
Clin Exp Pediatr. 2026;69(5):443-454.   Published online March 13, 2026
Question: Does epilepsy affect neurocognitive functions in pediatric drug-resistant focal epilepsy?
Finding: Diffusion magnetic resonance imaging (MRI) connectome could identify new imaging markers for seizure-associated structural abnormalities. New markers reflect deviations of local efficiency in neurocognitive networks and provide outstanding discretionary capacity for neurocognitive impairments, achieving an accuracy range of 90%–98% in the independent test patients.
Meaning: Supplementary MRI-driven decisions could be performed for personalized interventions to mitigate long-term neurocognitive effects.
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   (27 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
Original Article
Allergy
Regional differences in diagnosis and management of cow's milk allergy   (27 times)
Fabian Hendricx, Emma Robert, Jaime A. Ramirez-Mayans, Karen Rubi Ignorosa Arellano, Erick M. Toro Monjaraz, Yvan Vandenplas
Clin Exp Pediatr. 2024;67(11):601-607.   Published online October 28, 2024
· Although there is broad consensus on many aspects regarding the symptoms, diagnosis, and treatment of cow's milk allergy, the impact of geographical, cultural, and socioeconomic factors remains unestablished.
· Availability and cost of formula for the management of cow's milk allergy have a major impact on the therapeutic choice.
· Region-specific guidelines for the treatment of cow's milk allergy are required.
Review Article
Other
Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea   (27 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.
Original Article
Other
Impact of thyroid hormones and serum endothelin levels on pediatric asthma control: a case-control study of an Indian population   (27 times)
Murugaiyan Sathishbabu, Sathiya Ramasamy, Niranjjan Ramachandran, Soundararajan Palanisamy, Arulvijayavani Subramaniam
Clin Exp Pediatr. 2025;68(10):831-837.   Published online September 22, 2025
Question: What are the roles of thyroid hormones and endothelin in South Indian children with asthma?
Finding: Thyroid hormone and endothelin levels were significantly elevated in South Indian children with asthma; poorly controlled cases exhibited the highest levels. Elevated thyroid-stimulating hormone and endothelin levels were correlated with asthma severity.
Meaning: Serum endothelin is a potential surrogate marker for asthma severity that could aid the assessment and management of childhood asthma.
Nutrition
Human milk macronutrient composition and intake in relation to preterm infant growth: a cohort study   (27 times)
Eakkarin Mekangkul, Chonnikant Visuthranukul, Anongnart Sirisabya, Thaninee Chitsinchayakul, Santi Punnahitananda, Sirinuch Chomtho
Clin Exp Pediatr. 2026;69(5):428-436.   Published online April 22, 2026
Question: Is macronutrient intake, particularly that from human milk, distinctly associated with the growth of preterm infants?
Finding: Total protein and fat intake derived from human milk and fortifiers showed distinct positive associations with weight gain velocity.
Meaning: Particular attention to protein and fat composition during individualized human milk fortification can optimize weight gain in preterm infants.
Review Article
Gastroenterology
Value of transabdominal ultrasonography for diagnosing functional constipation in children: a systematic review and meta-analysis   (26 times)
Duc Long Tran, Phu Nguyen Trong Tran, Paweena Susantitaphong, Phichayut Phinyo, Palittiya Sintusek
Clin Exp Pediatr. 2025;68(2):127-135.   Published online November 13, 2024
Transabdominal ultrasonography is increasingly used as a novel modality for detecting pediatric functional constipation (FC). This systematic review and metaanalysis aimed to assess the diagnostic parameters of FC including rectal diameter (RD) and anterior rectal wall thickness. A systematic search was conducted of the Ovid MEDLINE, Embase, Scopus, and PubMed databases through September 29, 2023, to identify studies comparing RD...


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