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"Most viewed" Articles are from the articles published in 2022 during the last six month.

Original Article
Neurology
Neurodevelopmental outcomes and comorbidities of children with congenital muscular torticollis: evaluation using the National Health Screening Program for Infants and Children database   (3,318 times)
Og Hyang Kim, Seung Won Lee, Eun Kyo Ha, Ju Hee Kim, Yun Hye Jo, Seongyeong Rhie, Man Yong Han, Kyu Young Chae
Clin Exp Pediatr. 2022;65(6):312-319.   Published online December 9, 2021
Question: What comorbidities are increased in children with congenital muscular torticollis (CMT)? Are there differences in the neurodevelopmental outcomes of children with CMT who received physical therapy versus those who did not?
Finding: The risk of congenital musculoskeletal deformities is increased in CMT. Children who did not receive physical therapy were at greater risk of neurodevelopmental delay.
Meaning: In CMT, musculoskeletal comorbidities should be identified and active early treatment provided.
Review Article
Gastroenterology
Factors influencing development of the infant microbiota: from prenatal period to early infancy   (3,275 times)
Sujin Jeong
Clin Exp Pediatr. 2022;65(9):439-447.   Published online December 23, 2021
∙ Microbial colonization primarily occurs after birth but there may be some colonization in utero, although this remains highly controversial.
∙ Maternal factors during pregnancy affect the infant microbiota: diet, weight, gestational weight gain, and antibiotic usage.
∙ Microbes are passed from mother-to-infant during and after birth. Delivery mode, breastfeeding, early life antibiotic, and proton pump inhibitor treatment have the largest effects on microbial composition in early life.
∙ The early life gut microbiome plays an important role in the development of the immune system and metabolism.
Neurobehavior
Psychological aspects in children and parents of children with chronic kidney disease and their families   (3,255 times)
Alemsungla Aier, Priya Pais, Vijaya Raman
Clin Exp Pediatr. 2022;65(5):222-229.   Published online November 10, 2021
· Childhood chronic kidney disease (CKD) is complex and requires lifetime medical treatment.
· Children with CKD are at risk for emotional, behavioral, social, and academic difficulties that significantly affect their quality of life.
· Caring for children with CKD is stressful for families.
· These unique challenges are crucial and can negatively impact treatment outcomes.
· Awareness of and addressing these evolving psychosocial issues can foster their developing needs.
Gastroenterology
Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children   (3,241 times)
Yu Kyung Cho, Jin Lee, Chang Nyol Paik
Clin Exp Pediatr. 2023;66(9):377-383.   Published online August 21, 2023
· 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.
Neurology
Pediatric syncope: pearls and pitfalls in history taking   (3,176 times)
Jung Sook Yeom, Hyang-Ok Woo
Clin Exp Pediatr. 2023;66(3):88-97.   Published online February 15, 2023
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.
Original Article
Nutrition
Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis   (3,154 times)
Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Salman Khazaei
Clin Exp Pediatr. 2023;66(1):28-31.   Published online July 19, 2022
This study aimed to determine whether there is an association between not breastfeeding (versus breastfeeding) and the risk of autism spectrum disorders (ASD) among children. We found that the risk of ASD associated with not breastfeeding had an odds ratio of 1.81 (95% confidence interval, 1.35–2.27; I2=0 %). These findings suggest the importance of breastfeeding in decreasing the risk of ASD among children.
Review Article
Infection
Changes in age-specific seroprevalence of Japanese encephalitis virus and impact of Japanese encephalitis vaccine in Korea   (3,152 times)
Byung Ok Kwak, Young Jin Hong, Dong Hyun Kim
Clin Exp Pediatr. 2022;65(3):108-114.   Published online September 24, 2021
Since the introduction of a universal Japanese encephalitis (JE) vaccination program and urbanization, the incidence of JE has dramatically decreased in Korea. However, recent JE cases have occurred, predominantly among unvaccinated adults and with a shift in age distribution. Continuous surveillance of the seroprevalence of JE is required to establish a proper immunization policy in Korea.
Cardiology
Heart failure in children and adolescents: an update on diagnostic approaches and management   (3,144 times)
Amit Agrawal, Dalwinder Janjua, Abdulrahman Ahmed Alsayed Ali Zeyada, Ahmed Taher Elsheikh
Clin Exp Pediatr. 2024;67(4):178-190.   Published online June 19, 2023
· 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.
Original Article
Neonatology (Perinatology)
Efficacy of body position on gastric residual in preterm infant: a systematic review and meta-analysis   (3,125 times)
Kurvatteppa Halemani, Alwin Issac, Sanjay Dhiraaj, Prabhaker Mishra
Clin Exp Pediatr. 2023;66(6):262-270.   Published online November 30, 2022
Breastfeeding and it's tolerance are the positive indicators for preterm babies. Placing the preterm infant in the right lateral or prone position after feed had lesser gastric residual volume compared to placing them in left lateral or supine positions. The post-feed position is a vital element in enhancing feeding tolerance, mechanical functions of the gastrointestinal tract and the overall development of preterm infants.
Review Article
Neonatology (Perinatology)
Breastfeeding and vitamin D   (3,114 times)
Ju Sun Heo, Young Min Ahn, Ai-Rhan Ellen Kim, Son Moon Shin; for the Korean Society of Breastfeeding Medicine
Clin Exp Pediatr. 2022;65(9):418-429.   Published online December 14, 2021
∙ Exclusively breastfed infants are at risk of developing vitamin D deficiency associated with hypocalcemia, rickets, and various health outcomes.
∙ The prevalence of vitamin D deficiency in breastfed infants differs vastly between studies and nations at 0.6%–91.1%.
∙ The vitamin D content of breast milk does not meet the requirements of exclusively breastfed infants.
∙ Most international guidelines recommend that breastfed infants be supplemented with 400 IU/day of vitamin D during the first year of life.
∙ Vitamin D intake (milk+supplements) of 800 IU/day can be considered in preterm infants along with biochemical monitoring.
Neurology
Rotavirus infection-associated central nervous system complications: clinicoradiological features and potential mechanisms   (3,110 times)
Kyung Yeon Lee
Clin Exp Pediatr. 2022;65(10):483-493.   Published online February 7, 2022
∙ Rotavirus infection-associated central nervous system (CNS) complications are fairly common in children.
∙ Common clinicoradiological features include benign convulsions with mild gastroenteritis, acute encephalopathies/encephalitis, cerebellitis, and neonatal rotavirus-associated leukoencephalopathy.
∙ Possible mechanisms for CNS complications include direct viral invasion into the brain via several potential routes such as the blood-brain barrier and vagus nerve, and entry of various brain-damaging mediators and activated immune cells into the brain.
General Pediatrics
Korean Developmental Screening Test for Infants and Children (K-DST): development, applications, and implications for future early childhood development interventions   (3,083 times)
Dooyoung Kim, Young June Choe, Bilal Aurang Zeb Durrani, EunYoung Kim, Junghye Byeon, Baik-Lin Eun
Clin Exp Pediatr. 2023;66(7):288-293.   Published online December 22, 2022
· 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.
Neonatology (Perinatology)
Treatment of congenital cytomegalovirus infection   (3,072 times)
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(9):384-394.   Published online December 28, 2022
· 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.
Original Article
Allergy
Association between dyslipidemia and asthma in children: a systematic review and multicenter cohort study using a common data model   (3,054 times)
Ji Eun Lim, Hye Min Kim, Ju Hee Kim, Hey Sung Baek, Man Yong Han
Clin Exp Pediatr. 2023;66(8):357-365.   Published online June 14, 2023
Question: Is dyslipidemia a risk factor for asthma in children?
Finding: This was a comprehensive systematic review and retrospective multicenter study of the association between dyslipidemia and asthma in children. In a multicenter cohort analysis using the Observational Medical Outcomes Partnership Common Data Model, elevated total cholesterol levels were associated with increased risk of asthma development.
Meaning: These findings suggest an association between dyslipidemia and asthma in children.
Neurology
Effectiveness of Helmet therapy for infants with moderate to severe positional plagiocephaly   (3,036 times)
Jeongho Kim, Jina Kim, Kyu Young Chae
Clin Exp Pediatr. 2024;67(1):46-53.   Published online December 5, 2023
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.
General Pediatrics
Effect of maternal and child factors on stunting: partial least squares structural equation modeling   (3,026 times)
Agus Santosa, Essa Novanda Arif, Dinal Abdul Ghoni
Clin Exp Pediatr. 2022;65(2):90-97.   Published online May 4, 2021
Question: What effects do maternal and child factors have on stunting? Are there significant indicators of stunting?
Finding: Child and maternal factors had 49.8% and 30.3% effects on stunting, respectively. The primary child factor was infant formula dose, while the primary maternal factor was nutritional status.
Meaning: More attention to nutritional status during pregnancy and ensuring the appropriate dose of infant formula at ages 6–24 months can prevent stunting.
Review Article
Neurology
Promising candidate cerebrospinal fluid biomarkers of seizure disorder, infection, inflammation, tumor, and traumatic brain injury in pediatric patients   (2,998 times)
Seh Hyun Kim, Soo Ahn Chae
Clin Exp Pediatr. 2022;65(2):56-64.   Published online August 23, 2021
· Pediatric cerebrospinal fluid (CSF) components have been extensively evaluated as biomarkers of various neurologic diseases.
· Several promising candidate CSF biomarkers, including Tau, glial fibrillary acidic protein, neuron-specific enolase, S100β, and interleukins, have been studied in pediatric patients with seizure disorders, central nervous system infections, inflammation, tumors, hypoxic-ischemic encephalopathy, traumatic brain injuries, intraventricular hemorrhage, and congenital hydrocephalus.
· Circulating microRNAs in the CSF are a promising class of biomarkers for various neurological diseases.
Cardiology
Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections   (2,966 times)
Young Hwan Lee
Clin Exp Pediatr. 2023;66(1):1-11.   Published online June 22, 2022
· 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.
Nutrition
Association of gut microbiota with obesity in children and adolescents   (2,948 times)
Ky Young Cho
Clin Exp Pediatr. 2023;66(4):148-154.   Published online November 16, 2022
The gut microbiota is an emerging factor in the development of pediatric obesity, which is affected by renowned risk factors such as diet, lifestyle, and socioeconomic status. This review aimed to describe the association between the gut microbiota and childhood obesity.
Neurology
Electroencephalography source localization   (2,938 times)
Tae-Hoon Eom
Clin Exp Pediatr. 2023;66(5):201-209.   Published online December 29, 2022
· Electroencephalography (EEG) directly images the electrical activity of neurons at a higher temporal resolution than other neuroimaging techniques.
· EEG is still widely used in brain function research due to its advantages.
· Forward and inverse problems of EEG analyses require solutions.
· Methods such as the dipole and distributed source models have been introduced.
· Applications of EEG are expanding with the integration of other technologies and large-scale data.
Original Article
Neonatology (Perinatology)
Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis   (2,915 times)
Asha P. Shetty, Kurvatteppa Halemani, Alwin Issac, Latha Thimmappa, Sanjay Dhiraaj, Radha K, Prabhaker Mishra, Vijai Datta Upadhyaya
Clin Exp Pediatr. 2024;67(2):104-115.   Published online November 14, 2023
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.
Neonatal sepsis-causing bacterial pathogens and outcome of trends of their antimicrobial susceptibility a 20-year period at a neonatal intensive care unit   (2,911 times)
Woo Sun Song, Hye Won Park, Moon Youn Oh, Jae Young Jo, Chae Young Kim, Jung Ju Lee, Euiseok Jung, Byong Sop Lee, Ki-Soo Kim, Ellen Ai-Rhan Kim
Clin Exp Pediatr. 2022;65(7):350-357.   Published online December 9, 2021
Question: What is prevalence of bacterial pathogens causing sepsis and their antimicrobial susceptibility over 20 years?
Finding: Coagulase-negative remains most common causative organism. The most common gram-negative organism was Klebsiella pneumonia. The susceptibility of staphylococcus aureus and K. pneumonia showed increased susceptability to oxacillin, cefotaxime and amikacin, gentamicin, respectively.
Meaning: Answers to the question asked is important in choosing antimicrobials and to monitor emergence of multidrug-resistant organisms.
Review Article
Gastroenterology
Current diagnosis and image-guided reduction for intussusception in children   (2,905 times)
Jisun Hwang, Hee Mang Yoon, Pyeong Hwa Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho
Clin Exp Pediatr. 2023;66(1):12-21.   Published online July 4, 2022
· 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.
Original Article
Neonatology (Perinatology)
Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial   (2,893 times)
Mohammad Kazem Sabzehei, Behnaz Basiri, Maryam Shokouhi, Sajad Ghahremani, Ali Moradi
Clin Exp Pediatr. 2022;65(4):188-193.   Published online July 28, 2021
Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)?
Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects.
Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique.
Review Article
Endocrinology
Growth plate closure and therapeutic interventions   (2,878 times)
Ja Hyang Cho, Hae Woon Jung, Kye Shik Shim
Clin Exp Pediatr. 2024;67(11):553-559.   Published online October 28, 2024
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.
Genetics and Metabolism
Development of orphan drugs for rare diseases   (2,854 times)
Han-Wook Yoo
Clin Exp Pediatr. 2024;67(7):315-327.   Published online June 28, 2023
· Orphan disease is a rare disease, primarily affecting newborn and children. Vast majority of orphan diseases has genetic background.
· Orphan disease is individually rare. But as a whole, it is not rare, becoming a great socioeconomic burden.
· The diagnosis of rare genetic disease has been problematic, but recent progress of genome analysis technologies makes it faster and more precise.
· There are many unmet needs as to the curative treatment. However, the number of treatable rare diseases is growingly increasing owing to the development of biotechnology.
· Most orphan drugs are extremely expensive because of numer ous hurdles during the process of drug development as well as small number of patients.
Neonatology (Perinatology)
Updates in neonatal resuscitation: routine use of laryngeal masks as an alternative to face masks   (2,809 times)
Eun Song Song, Ga Won Jeon
Clin Exp Pediatr. 2024;67(5):240-246.   Published online July 11, 2023
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.
Nephrology (Genitourinary)
Kidney complications associated with COVID-19 infection and vaccination in children and adolescents: a brief review   (2,763 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.
Neurology
Worldwide national intervention of developmental screening programs in infant and early childhood   (2,756 times)
Seunghyo Kim
Clin Exp Pediatr. 2022;65(1):10-20.   Published online September 30, 2021
∙ Prevalence rate of developmental disabilities has been reported from 8% to 15% and its rate is increasing worldwide.
∙ The critical period of intervention for developmental delay is before the child reaches 3 years of age.
∙ All primary care pediatricians should conduct developmental surveillance and screening tests to infants and children at scheduled visits. Through this, they are liable for providing early identification and timely intervention.
Original Article
Other
Plastic bottle feeding produces changes in biochemical parameters in human infants – A pilot study   (2,727 times)
Mahendra K. Pant, Abul. H. Ahmad, Manisha Naithani, Jayanti Pant
Clin Exp Pediatr. 2022;65(9):459-465.   Published online May 19, 2022
Question: Plastic feeding bottles are used commonly to feed infants who cannot be breastfeed. Does plastic bottle feeding produce biochemical changes in infants?
Finding: The plastic bottles leach out endocrine disruptors and affects bodily functions in terms of biochemical alterations like increased blood urea, raised creatine-kinase–MB levels, and altered lipid profile in infants exposed to bottle feeding.
Meaning: Plastic bottles feeding alters bodily functions in infants.