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

Original Article
Oncology
HLA‒B*58:01 and skin reactions in pediatric hematology and oncology patients treated with allopurinol   (12 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.
Letter to the Editor
Pulmonology
Metabolic syndrome and pulmonary dysfunction in asthmatic children during the COVID-19 pandemic   (11 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
Original Article
Developmental and Behavioral Medicine
Effectiveness of online responsive teaching in young children with developmental disabilities: a pilot study   (11 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.
Letter to the Editor
Developmental and Behavioral Medicine
Efficacy of social skills group intervention among children with mild autism spectrum disorder   (11 times)
Lee Ling Low, Ker Yang Chua, Bih Hwa Ching
Clin Exp Pediatr. 2024;67(7):368-370.   Published online May 31, 2024
Editorial
Allergy
Advancements in food allergen immunotherapy: improving quality of life and reducing risks   (11 times)
Jihyun Kim
Clin Exp Pediatr. 2024;67(12):672-674.   Published online July 31, 2024
· Pediatric food allergies considerably impair patient and family quality of life, particularly those with persistent allergies to common food allergens.
· Recent research has focused on developing diverse approaches to food allergen immunotherapy, showing promising outcomes of oral, sublingual, and epicutaneous immuno therapies.
· Critical considerations in immunotherapy candidate selection underscore the need for personalized approaches and reliable biomarkers in future studies to improve treatment outcomes.
Original Article
Endocrinology
Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency   (11 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.
Genetics and Metabolism
Role of microRNA-498 and microRNA-410 in neonatal hypoxic-ischemic encephalopathy   (11 times)
Eman Salah Eldeen Arafat, Hasnaa Hesham Abotaleb, Dina Abdel Razek Midan, Abdel Hamid Abdo Ismail, Zeinab Sabri Abouzouna
Clin Exp Pediatr. 2025;68(7):512-521.   Published online February 26, 2025
Question: Is it role of microRNA-410 (miRNA-410) and microRNA-498 (miRNA-498) in neonatal hypoxic-ischemic encephalopathy (HIE)?
Findings: miRNA-498 and miRNA-410 can be auxiliary diagnostic and prognostic tools for neonatal HIE.
Meaning: we can use miRNA-498 and miRNA-410 as markers and indicator for HIE.
Hematology
Hyperhomocysteinemia in pediatric β-thalassemia: links to vitamin cofactor deficiencies and oxidative stress   (11 times)
Arzu Dadashova, Gunay Aliyeva, Rana Rahimova, Gulnara Azizova, Khayala Mammadova
Clin Exp Pediatr. 2025;68(10):819-830.   Published online July 8, 2025
Question: What are the biochemical and clinical correlates of hyperhomocysteinemia in pediatric β-thalassemia, and how does it relate to vitamin status, oxidative stress, and splenectomy?
Finding: Most pediatric β-thalassemia patients exhibited severe hyperhomocysteinemia, which was strongly associated with folate and B12 deficiencies and influenced oxidative stress patterns, particularly in splenectomized individuals.
Meaning: These findings suggest that routine monitoring and correction of B-vitamin deficiencies may mitigate hyperhomocysteinemia-related risks in pediatric thalassemia.
Editorial
Neonatology (Perinatology)
Impacts of maternal COVID-19 during pregnancy on neonatal health and epidemiology   (10 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.
Exploring the role of laryngeal masks in neonatal resuscitation   (10 times)
Euiseok Jung
Clin Exp Pediatr. 2024;67(5):247-248.   Published online December 28, 2023
· Laryngeal masks (LMs) offer stable airway access and skill retention advantages, making them promising alternatives to positive-pressure ventilation in neonatal care.
· The ease of teaching LM insertion techniques to less experienced providers addresses the need for swift intervention and skill retention.
· Careful consideration of the benefits and challenges of LMs is essential in determining their effective integration into enhanced neonatal resuscitation protocols.
Review Article
Other
Use of virtual reality in children in a broad range of medical settings: a systematic narrative review of recent meta-analyses   (10 times)
Emily Antonovics, Grammatina Boitsios, Thomas Saliba
Clin Exp Pediatr. 2024;67(6):274-282.   Published online May 21, 2024
· Virtual reality (VR) is becoming increasingly common for entertainment and in medical settings.
· VR is useful for treating children with cerebral palsy.
· VR can help with attention deficit/hyperactivity disorder symptoms.
· VR can decrease pain perception in children undergoing burn wound care.
· VR can reduce preoperative anxiety.
· VR can reduce fear and pain during needle-involving procedures.
Editorial
Neurobehavior
Importance of pediatrician’s role in preventing positional plagiocephaly   (10 times)
Hee-Jeong Kang
Clin Exp Pediatr. 2024;67(6):294-295.   Published online May 21, 2024
· Plagiocephaly is characterized by the asymmetrical shape of a baby’s head.
· Since positional plagiocephaly is associated with developmental delay and further musculoskeletal problems, early detection allows for timely intervention and prevents worsening of the condition.
· Pediatricians can educate parents about proper head positioning and encourage supervised tummy time during awake hours.
Genetics and Metabolism
Advancing orphan drug development for rare diseases   (10 times)
Jung Min Ko
Clin Exp Pediatr. 2024;67(7):356-357.   Published online November 17, 2023
· Rare diseases present unique challenges and unmet needs for which the development of orphan drugs tailored to them offers hope.
· Despite the hurdles posed by limited patient populations, orphan drug designations from regulatory agencies provide incentives, such as extended market exclusivity and tax credits, that ignite transformative advances.
· Scientific progress in genomics, personalized medicine, and analytics empowers precise interventions by decoding genetic anomalies and encouraging effective treatments.
Original Article
Neonatology (Perinatology)
Protective effect of recombinant interleukin-10 on newborn rat lungs exposed to short-term sublethal hyperoxia   (10 times)
Hyeon-Soo Lee, Young-Joon Ryu, Min-Jae Lee
Clin Exp Pediatr. 2024;67(10):540-549.   Published online September 27, 2024
Lung injury is generated from the early stage of hyperoxia through the biologic effects of cell death and inflammatory response, which eventually leads to evolution of bronchopul-monary dysplasia. Therefore, a protective measure against hyperoxia-induced lung injury is needed. The present study observed that anti-inflammatory cytokine, interleukin-10 had protective effects on newborn rat lungs from injury induced at the early stage of hyperoxia, by preventing cell death and down-regulating inflammatory response.
Editorial
Infection
Preventing bloodstream infections in children after liver transplantation   (10 times)
Young June Choe
Clin Exp Pediatr. 2024;67(11):599-600.   Published online April 18, 2024
Liver transplantation (LT) is crucial for children with end-stage liver diseases, yet bloodstream infections (BSI) pose significant risks, despite medical advancements. Immunosuppressants, essential for preventing organ rejection, heighten infection susceptibility. Understanding BSI organisms is vital due to antimicrobial resistance. Pediatric LT recipients have unique risk factors, demanding tailored preventive measures. This systematic review on bacterial BSI emphasizes the urgency of effective prevention strategies, considering the high incidence and distinct organism profile. Further research is vital for optimizing antibiotic management and improving outcomes for this vulnerable population.
Original Article
Infection
Clinical outcomes and healthcare utilization of hospitalized children with influenza versus COVID-19   (10 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.
Editorial
Allergy
Effect of metabolic syndrome on pulmonary dysfunction in children with asthma   (10 times)
Hyo-Bin Kim
Clin Exp Pediatr. 2025;68(2):136-137.   Published online November 13, 2024
· The prevalence of metabolic syndrome increased in Korean children during the coronavirus disease 2019 pandemic owing to reduced physical activity resulting from social distancing.
· Metabolic syndrome impacts pulmonary dysfunction in childhood asthma.
· Further studies are needed to understand the mechanism linking asthma and metabolic syndrome and develop interventions.
Original Article
Gastroenterology
Differences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing   (10 times)
Dae Yong Yi, Hong-Jai Park, Min Sun Shin, Hyoungsu Kim, Sang Jin Lee, Insoo Kang
Clin Exp Pediatr. 2025;68(2):141-152.   Published online January 10, 2025
Question: Is there a difference in immune cells in human breast milk by parity?
Finding: There were higher proportions of monocytes and T/B cells in the primiparous and multiparous group, respectively. The expression of genes with a direct role in the infant immune system and immune response-related genes were highest in the primiparous group
Meaning: There were parity-dependent differences in the expression of genes between innate and adaptive immune cells.
Review Article
Other
Peripheral nerve sheath tumors in the head and neck in patients with APC gene deletion mutations: a case report and scoping review of the literature   (10 times)
Koral M. Blunt, Monirah Albathi, Miriam Conces, Tendy Chiang
Clin Exp Pediatr. 2025;68(6):428-433.   Published online January 13, 2025
In this report, we describe our experience with a patient with an APC-related genetic syndrome who presented with a rare palatal lesion with characteristics of a schwannoma. We discuss the role of immunohistochemical staining in discerning the differential diagnosis.
Original Article
Nephrology (Genitourinary)
COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus   (10 times)
Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn
Clin Exp Pediatr. 2025;68(6):454-462.   Published online February 3, 2025
Question: What is the acceptance rate for coronavirus disease 2019 vaccination among parents of children with systemic lupus erythematosus (SLE)?
Finding: One-third of parents were hesitant to vaccinate their child. Parental willingness to vaccinate themselves, older patient age, and belief in the vaccine's potency were associated with vaccine acceptance.
Meaning: These findings highlight the need for targeted interventions to improve vaccine acceptance among parents of children with SLE.
Correspondence
Nephrology (Genitourinary)
Authors' reply: a commentary on “COVID-19 vaccine hesitancy among parents of children with systemic lupus erythematosus”   (10 times)
Karnchanit Sausukpaiboon, Nuanpan Penboon, Pornpimol Rianthavorn
Clin Exp Pediatr. 2025;68(8):626-627.   Published online July 18, 2025
Original Article
Basic Research
Linezolid mitigates tissue injury in experimental model of pediatric testicular torsion: TLR-4/MAPK/NF-κB involvement   (10 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.
Hematology
Evaluation of Bak and Bcl-Xl gene expression among pediatric patients with acute primary immune thrombocytopenia   (10 times)
Amira Zaki Badawy, Samia Hassan Kandel, Iman Aly Ahmedy, Mahmoud Ahmed Elhawy, Sally Mohamed El-Hefnawy, Dina Fouad Sief El-Nasr Zidan, Hanan Hassan El-sheity
Clin Exp Pediatr. 2025;68(11):901-908.   Published online August 6, 2025
The B-cell lymphoma protein 2 family proteins Bak and Bcl- Xl, important markers of apoptosis, may contribute to primary immune thrombocytopenia (ITP). Thus, their expression may serve as biomarkers for the diagnosis and monitoring of pediatric ITP. Targeting these pathways may improve platelet survival, particularly in treatment-resistant cases. Personalized treatments based on apoptotic profiles can optimize therapy and reduce the unnecessary use of immunosuppressive drugs.
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   (9 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.
Review Article
Rheumatology
Double-negative T cells in pediatric rheumatic diseases   (9 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
Immunology
Serum bactericidal activity against meningococcus in patients with systemic lupus erythematosus   (9 times)
Soyoung Lee, Kyung-Hyo Kim, Ji Hyen Lee, Han Wool Kim
Clin Exp Pediatr. 2025;68(5):362-369.   Published online January 13, 2025
Question: What is the level of immunity against meningococcal infections in patients with systemic lupus erythematosus (SLE) under the age of 19, and is vaccination against meningococcus necessary for these patients, given their susceptibility to infections due to immunosuppressive treatments and disease characteristics?
Finding: Although some of our study patients exhibited serum bactericidal activity against meningococci, most remained seronegative.
Meaning: These findings suggest that patients with SLE who are at risk of meningococcal infection receive appropriate vaccinations.
Gastroenterology
Somatic symptom severity during acute illnesses among children with functional gastrointestinal disorders   (9 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.
Infection
Carbapenem resistance in gram-negative pathogens in an Iranian hospital: high prevalence of OXA-type carbapenemase genes   (9 times)
Setareh Mamishi, Reihaneh Hosseinpour Sadeghi, Sadaf Sajedi Moghaddam, Babak Pourakbari, Shiva Poormohammadi, Maryam Sotoudeh Anvari, Shima Mahmoudi
Clin Exp Pediatr. 2025;68(1):65-72.   Published online October 31, 2024
Question: What is the prevalence of carbapenem resistance in gram-negative bacteria and associated carbapenemase genes?
Findings: This study identified a notable prevalence of carbapenem-resistant gram-negative isolates, with Escherichia coli being the predominant contributor, follow ed by Klebsiella pneumoniae, Acinetobacter baumannii, while bla OXA48 was the most prevalent carbapenemase gene.
Meaning: These findings highlight the urgent need for proactive measures including the rapid detection of carbapenemase- producing isolates and effective infection control.
Editorial
Basic Research
Stem cell mining: urine cells to biobanking   (9 times)
Yong Joo Ahn
Clin Exp Pediatr. 2025;68(10):761-762.   Published online September 24, 2025
· A safe and accessible source of somatic cell generating induced pluripotent stem cells (iPSCs) in pediatric neurogenic disorders
· A noninvasive and simple method for isolating urine cells, which can effectively reprogram into pluripotent stem cells using episomal vectors
· Establishing a urine-derived iPSC bank as a reliable and scalable resource for disease modeling, therapeutic testing, and personalized medicine in pediatric neurogenic disorders.
Pulmonology
Telomere biology disorders in childhood interstitial lung disease: new insights from the chILD-EU cohort   (9 times)
Andrew Courtwright
Clin Exp Pediatr. 2026;69(7):542-544.   Published online June 30, 2026
Greiner-Mai et al. expand recognition of telomere biology disorder (TBD)-associated interstitial lung disease (ILD) in children, demonstrating heterogenous radiographic and ILD subtypes in combination with variable extrapulmonary phenotypes, even in the absence of ultrashort peripheral blood telomere length (TL). While their findings highlight some of the limitations of current TL testing methods, they introduce critical questions regarding family screening and the role of antifibrotic and telomere-directed therapies in children with TBD-related ILD.


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