"Most viewed" Articles are from the articles published in 2023 during the last six month.
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Despite worldwide acceptance of acetaminophen (paracetamol) in pediatric medicine, careful examination reveals no valid objections to the conclusion that early exposure to acetaminophen causes neurodevelopmental injury in susceptible babies and children. Nevertheless, debate that early exposure to acetaminophen causes neurodevelopmental injury has centered around the prenatal period, evidence of which is relatively limited compared to that in the postnatal period, which is the time of greatest absolute and relative risk. |
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· Most commonly confirmed causes of community-acquired pneumonia (CAP) in children are Mycoplasma pneumoniae (8%–40%) and respiratory syncytial virus (15%–20%). · Pyogenic bacteria, most commonly Streptococcus pneumoniae (40%–50%) and Streptococcus pyogenes (10%–25%), are detected in 2%–5% of children hospitalized with CAP. · CAP should be diagnosed conservatively according to clinical and radiological criteria. · The etiology should be identified via appropriate test result interpretation. |
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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. |
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· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures. · Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections. · Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures. |
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· A detailed history and comprehensive physical examination remain the cornerstones for establishing a diagnosis of global developmental delay/intellectual disability (GDD/ID). · Comprehensive surveillance and screening programs play a significant role in the early detection of GDD. · Whole-exome sequencing is highly recommended as first- or second-line testing for individuals with idiopathic GDD/ID. · Early intervention by a well-versed multidisciplinary team can significantly improve the outcomes and prognosis of GDD/ID. |
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Question: Can sigh breaths (Sighs) application during high-frequency oscillatory ventilation (HFOV) decrease partial pressure of carbon dioxide (PaCO2) levels? Finding: The mean PaCO2 level after Sighs during HFOV was significantly decreased compared to that after HFOV alone (mean difference, -3.6 mmHg). Meaning: HFOV plus Sighs functionality can reduce PaCO2 levels. However, further studies are required to conclusively determine the effects of Sighs. |
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Asthma is the most common chronic disease among children. Although asthma in children may spontaneously improve, it continues into adulthood in many cases. Therefore, appropriate disease management and medication are essential. Consistent and objective guidelines are needed to manage pediatric asthma and related adverse reactions. |
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Height gains result from longitudinal bone growth. Upon adequate growth, growth plate closure limits longitudinal bone growth. To date, gonadotropin-releasing hormone analogs, aromatase inhibitors, C-type natriuretic peptide analogs, and fibroblast growth factor receptor 3 inhibitors have been studied or used as therapeutic interventions to delay growth plate closure and increase human height. The development of more effective therapeutic modalities for short stature, precocious puberty, and skeletal dysplasia is anticipated. |
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· Since 1960, South Korea's TFR decreased from 6.33 to 0.78 in 2022, below the 2.1 replacement level since 1983, with women's average age at first marriage rising to 31.3 in 2022. · Policies needed: financial incentives, longer parental leave, better childcare. · The U.S. (15.3% immigrants) and Germany (18.8%) use immigration to maintain demographic stability, a strategy South Korea is considering. |
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· This review discusses the development and application of the Korean Developmental Screening Test for Infants and Children (K-DST) for ensuring early childhood development. · Various studies have demonstrated the integral role of the K-DST in facilitating the detection of developmental delays and delivery of timely interventions. · The tailoring of the K-DST to Korean infants and children suggests that other countries may further translate and adapt it. |
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· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates. · Etiologies vary, and up to 80% of cases are genetic. · Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention. |
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· 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. |
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· The etiology of Kawasaki disease (KD) is unclear, but its clinical, epidemiological, and pathophysiological characteristics are strongly associated with infectious diseases. · In the coronavirus disease 2019 pandemic era, viruses are attracting the most attention. Sudden acute respiratory syndrome coronavirus 2 infection causes various hyperinflammation in children that require differentiation from KD. · Immune responses in patients with KD may be induced by host cell damage. To effectively prevent and treat KD, the genetic background and immune responses of KD patients and triggering pathogens require identification. |
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Question: Does zinc supplementation along with probiotics affect disease severity or clinical outcomes of children with acute diarrhea? Findings: This study indicated that zinc supplementation and probiotics had no effect on clinical improvement or disease severity among pediatric patients with acute diarrhea. Meaning: Children who received probiotics plus zinc recovered faster than those who received probiotics only. |
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Question: Is helmet therapy effective for positional plagiocephaly? What factors influence helmet therapy efficacy for positional plagiocephaly? Finding: Helmet therapy is effective for infants with moderate to severe positional plagiocephaly, and its effectiveness is influenced by age at treatment initiation, severity of head asymmetry, and daily duration of helmet wear. Meaning: Pediatricians should initiate helmet therapy for positional plagiocephaly sooner, ideally before 9 months of age, to maximize treatment efficacy. |
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· Pediatric heart failure (PHF) is a clinical syndrome featuring various symptoms (shortness of breath, ankle swelling, fatigue) and signs (pulmonary crackles, peripheral edema). · Congenital heart diseases are the most common underlying etiology of PHF, whereas myocarditis and primary cardio-myopathies are common in children without structural ab-normalities. · PHF pathophysiology is complex and multifactorial and varies by etiology and age. · PHF management includes decongestive therapy, treatment of underlying causes, preventing progression, and managing pulmonary or systemic obstructions. · Drugs should be chosen based on pharmacodynamics, clinical manifestations, hemodynamic state, and renal function. |
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· Among survivors, 60.9% of infants born at 22 weeks’ gestation had moderate to severe impairments, whereas 50.3% born at 23 weeks’ and 42.2% at 24 weeks’ gestation had moderate to severe impairments. · Moderate and late preterm infants reportedly have less severe disease than very preterm infants, but they still experience adverse neurodevelopmental outcomes. · The careful follow-up and early detection of developmental problems in these patients are required. |
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· Intussusception, the most common cause of small bowel obstruction in young children, has an overall incidence in Korea of 28.3 cases per 100,000 person-years. · Its cause is idiopathic inmost cases, although viral or bacterial gastroenteritis has beenpostulated as a cause. Approximately 4% of children have pathological lead points for intussusception, and Meckel’s diverticulum is the most common cause. · Intussusception in preterm infants is extremely rare. Older children (>5 years of age) are at increased risk of pathological lead points. |
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Question: What is the effect of nonpharmacological interventions on postoperative pain and anxiety among children. Finding: Nurse-provided distraction interventions reduce pain and anxiety among pediatric surgical patients. Meaning: The findings suggest that nonpharmacological interventions provided postoperatively to children reduce their pain and anxiety levels. |
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Question: What emotions do parents experience when their newborns are admitted to the neonatal intensive care unit (NICU)? Finding: Mothers experienced more anxiety (51%), depression (31%), and stress (41%) symptoms than fathers (26%, 12%, and 22%, respectively). Meaning: Parents often experience anxiety, stress, and depression following NICU admission. Healthcare workers are responsible for providing regular parental counseling. |
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· 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). |
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· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition. · SIBO is prevalent in children and adolescents with functional abdominal pain disorders. · Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria. · Breath tests are safe and noninvasive. · Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics. |
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· The gut microbiota can alter a host’s brain development and behavior. · Gut bacteria communicate with the brain via the microbiota-gut-brain axis. · Fecal microbial transplantation is a promising treatment strategy for autism spectrum disorder. |
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· Primary pediatricians should play a key role in the diagnosis and treatment of attention-deficit/hyperactivity disorder (ADHD). · The Diagnostic and Statistical Manual of Mental Disorders, fifth edition, has lowered the diagnostic threshold for older teens and adults and a comorbid diagnosis with autism is now allowed. · The American Academy of Pediatrics had added recommendation-related comorbid conditions in its guideline and the Society of Developmental and Behavioral Pediatrics recently developed a complex ADHD guideline. · The European ADHD Guideline Group recently developed a guideline for managing ADHD during the coronavirus disease 2019 pandemic. |
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An accurate diagnosis depends on correct history taking and its interpretation. An in-depth understanding of the symptoms of syncope in connection with its pathophysiology can lead to avoiding critical pitfalls in the diagnostic process of history taking. |
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To prevent food allergy in infants, based on the dual allergen exposure hypothesis, we recommend a personalized approach consisting of both skin intervention (eczema treatment to achieve early remission and well-controlled skin without eczema to prevent percutaneous immunoglobulin E sensitization) and oral intervention (early allergenic food introduction). |
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· Congenital cytomegalovirus (CMV) infection is among the most common causes of nongenetic sensorineural hearing loss. · Congenital CMV is initially treated with intravenous ganciclovir for 2–6 weeks and switched to oral valganciclovir, or with oral valganciclovir for the entire 6-month period. · Infants with congenital CMV require periodic monitoring of absolute neutrophil count, platelet count, and blood urea nitrogen, creatinine, liver function tests, audiological, ophthalmological, and developmental tests during antiviral medication. |
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In neonatal resuscitation: · Laryngeal masks are recommended when endotracheal intubation or positive-pressure ventilation fails. · Laryngeal masks are useful even during chest compressions. · Laryngeal masks aid neonates >34 weeks’ gestation and/or with a birth weight >2 kg. · Main usage barriers include limited experience (81%), preference for endotracheal tubes (57%), and lack of awareness (56%). · Second-generation laryngeal masks have a built-in esophageal drainage tube that prevents regurgitation into the glottis, and an orogastric tube can be inserted within the esophageal drainage tube to protect against gastric inflation. |
Clinical and Experimental Pediatrics is an open access journal. All articles are distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/)
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