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

Review Article
Neurobehavior
Jeopardized mental health of children and adolescents in coronavirus disease 2019 pandemic   (2,723 times)
Bohyun Jin, Sohee Lee, Un Sun Chung
Clin Exp Pediatr. 2022;65(7):322-329.   Published online June 3, 2022
∙ The coronavirus disease 2019 (COVID-19) pandemic has required preventive measures like self-quarantine, school closures, and lockdown, which ultimately make youth directly and indirectly vulnerable to depression, anxiety, posttraumatic stress disorder, and somatization.
∙ Child abuse is more common in the COVID-19 era than previously.
∙ Pediatricians should carefully examine parental and child mental health to directly and indirectly aid their physical and mental health.
Pulmonology
Evidence-based management guidelines for noncystic fibrosis bronchiectasis in children and adolescents   (2,713 times)
Eun Lee, Kyunghoon Kim, You Hoon Jeon, In Suk Sol, Jong Deok Kim, Taek Ki Min, Yoon Ha Hwang, Hyun-Ju Cho, Dong In Suh, Hwan Soo Kim, Yoon Hee Kim, Sung-Il Woo, Yong Ju Lee, Sungsu Jung, Hyeon-Jong Yang, Gwang Cheon Jang
Clin Exp Pediatr. 2024;67(9):418-426.   Published online January 23, 2024
· 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).
Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies   (2,688 times)
Eun Kyo Ha, Ju Hee Kim, Man Yong Han
Clin Exp Pediatr. 2023;66(11):465-474.   Published online June 19, 2023
· Current definitions of long coronavirus disease (COVID) in children and adolescents vary in duration, ranging from 4 to 12 weeks or more.
· The clinical spectrum of long COVID in children and adolescents comprises a wide range of symptoms and might be a multisystem disorder.
· Persistent health problems with a prevalence of 1%–66.5% were reported in children and adolescents after COVID-19, with a higher incidence of persistent single or multiple symptoms.
Allergy
Natural course of IgE-mediated food allergy in children   (2,659 times)
Kyunguk Jeong, Sooyoung Lee
Clin Exp Pediatr. 2023;66(12):504-511.   Published online June 14, 2023
· Dendritic, regulatory T, and regulatory B cells significantly contribute to the natural course of food allergy.
· Cow’s milk and hen’s egg allergies tend to resolve in earlier childhood but recent studies show that 50% of patients still persist into school age.
· The potential factors affecting the natural course of food allergy are age at diagnosis, symptom severity, sensitization status and its change rate, and external factors such as diet and interventions.
· There is a considerable possibility of food allergy outgrow if specific IgE levels are 2–5 kUA/L or less, but other factors such as age and recent symptoms should be considered together.
· With a clear understanding of the natural course of food allergy, pediatricians can provide appropriate assessment and interventions to our patients, and consequently can help patients overcome their food allergy and improve the social safety net.
Original Article
Endocrinology
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis   (2,643 times)
Azam Maleki, Saeid Bashirian, Ali Reza Soltanian, Ensiyeh Jenabi, Abdollah Farhadinasab
Clin Exp Pediatr. 2022;65(2):85-89.   Published online April 15, 2021
Question: Have polycystic ovary syndrome (PCOS) increased risk of having an offspring with attention-deficit/hyperactivity disorder (ADHD)?
Finding: Six articles (3 cohort and 3 case-control studies; 401,413 total ADHD cases) met the study criteria. Maternal PCOS was associated with an increased risk of ADHD in the offspring based on odds ratio (OR) and relative ratio (RR) (OR, 1.42; 95% confidence interval [CI], 1.27–1.57) and (RR, 1.43; 95% CI, 1.35–1.51), respectively.
Meaning: Our study showed that maternal PCOS is a risk factor for ADHD.
Review Article
Cardiology
Implication of microRNA as a potential biomarker of myocarditis   (2,598 times)
Jin-Hee Oh, Gi Beom Kim, Heeyoung Seok
Clin Exp Pediatr. 2022;65(5):230-238.   Published online March 2, 2022
· Myocarditis was recently examined quantitatively as inflammation of the heart muscle based on endomyocardial biopsy, and its noninvasive diagnosis remains unsatisfactory.
· Additionally, numerous miRNAs (miR-155, miR-146b, miR-590, miR-221, miR-222, etc.) coupled with inflammation or viral activation have been examined in myocarditis patients or mouse models.
· The recent identification of mmu-miR-721 (has-miR-Chr8: 96), a myocarditis-specific microRNA, demonstrated its potential as an acute myocarditis biomarker.
Infection
Four months of rifampicin monotherapy for latent tuberculosis infection in children   (2,581 times)
Chi Eun Oh, Dick Menzies
Clin Exp Pediatr. 2022;65(5):214-221.   Published online October 29, 2021
· Recently, the importance of a short-term treatment regimen including rifamycin has been highlighted in the treatment of latent tuberculosis infection (LTBI).
· Four prospective or retrospective studies in children consistently reported that a 4-month daily rifampicin regimen (4R) had a higher completion rate than and comparable safety to a nine-month daily isoniazid regimen.
· We suggest rifampicin 20–30 mg/kg/day for children aged 0–2 years and 15–20 mg/kg/day for children aged 2–10 years in 4R to treat LTBI.
Allergy
Skin and oral intervention for food allergy prevention based on dual allergen exposure hypothesis   (2,580 times)
Kiwako Yamamoto-Hanada, Yukihiro Ohya
Clin Exp Pediatr. 2024;67(10):477-485.   Published online June 14, 2023
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).
Original Article
Developmental and Behavioral Medicine
Neonatal risk factors associated with autism spectrum disorders: an umbrella review   (2,575 times)
Amir Mohammad Salehi, Erfan Ayubi, Salman Khazaei, Ensiyeh Jenabi, Saeid Bashirian, Zohreh Salimi
Clin Exp Pediatr. 2024;67(9):459-464.   Published online July 19, 2024
Question: What are the neonatal risk factors for autism spectrum disorder (ASD)?
Findings: Significant effect sizes were observed for congenital heart disease (odds ratio [OR], 1.35), macrosomia (OR, 1.11), low birth weight (OR, 1.63), very low birth weight (OR, 2.25), small for gestational age (OR, 1.17), jaundice (OR, 1.74), male sex (OR, 1.47), and Apgar score (OR, 1.40).
Meaning: These factors were identified as risk factors for ASD.
Review Article
Oncology
Application of 3-dimensional printing implants for bone tumors   (2,565 times)
Jong Woong Park, Hyun Guy Kang
Clin Exp Pediatr. 2022;65(10):476-482.   Published online December 23, 2021
∙ The application of 3-dimensional (3D) printing in orthopedic oncology is summarized into bone and tumor modeling, patient-specific instruments (PSIs), custom-made implants, and tissue engineering.
∙ The 3D-printed customized implant is the most central application, while modeling and PSI often play adjunct roles.
∙ Short-term surgical outcomes of custom-made 3D-printed implants are promising.
Gastroenterology
Update on eosinophilic gastrointestinal disease beyond eosinophilic esophagitis in children   (2,564 times)
Hye Ran Yang
Clin Exp Pediatr. 2023;66(6):233-239.   Published online January 3, 2023
· Eosinophilic gastrointestinal disease (EGID) is uncommon, with a prevalence of 1–30/100,000 in the general population; however, it is increasing worldwide.
· The diagnosis of EGID is based on histopathological findings of endoscopic mucosal biopsy in which tissue eosinophils are counted in each gastrointestinal tract segment of patients with chronic or recurrent gastrointestinal symptoms.
· Individualized treatment strategies, including adequate dietary and pharmacological therapy, may help improve outcomes of children with EGID.
Original Article
Other
Risk factors and screening timing for developmental dysplasia of the hip in preterm infants   (2,541 times)
Ga Won Jeon, Hye Jung Choo, Yong Uk Kwon
Clin Exp Pediatr. 2022;65(5):262-268.   Published online November 5, 2021
Question: When is the best screening timing and what is the risk factor for developmental dysplasia of the hip (DDH) in preterm infants?
Finding: Ultrasonography performed earlier than 38 weeks of postmenstrual age caused unnecessary subsequent ultrasonography. DDH did not occur predominantly on the left side or in breech infants.
Meaning: The screening timing, etiology, and risk factors for DDH in preterm infants are somewhat different from those in term infants.
Review Article
Infection
Etiological and pathophysiological enigmas of severe coronavirus disease 2019, multisystem inflammatory syndrome in children, and Kawasaki disease   (2,530 times)
Jung-Woo Rhim, Jin-Han Kang, Kyung-Yil Lee
Clin Exp Pediatr. 2022;65(4):153-166.   Published online November 23, 2021
· Severe cases of coronavirus disease, Kawasaki disease (KD), and multisystem inflammatory syndrome in children (MIS-C) share similar findings: a protracted clinical course, multiorgan involvement, and similar activated biomarkers.
· Here we propose etiological agents in KD and MIS-C as species in the microbiota and introduce a common pathogenesis through the protein-homeostasis-system hypothesis.
· Early proper dose of corticosteroids and/or intravenous immunoglobulin may help to reduce morbidity and mortality in these diseases.
Nephrology (Genitourinary)
Effects of diethylene glycol contamination of pharmaceutical products on unexplained acute kidney injury in children: a systematic review   (2,530 times)
Sani Rachman Soleman, Muhammad Luthfi Adnan, Hilmi Ardian Sudiarto, Satria Bintang Mahathma, Alya Ayu Tazkia, Hana Afifah Firdaus, Alfreda Amelia Khotijah, Miranti Dewi Pramaningtyas, Emi Azmi Choironi
Clin Exp Pediatr. 2024;67(8):395-402.   Published online January 4, 2024
A recent unexplained acute kidney injury (AKI) outbreak due to pharmaceutical product contamination with diethylene glycol (DEG) raises public attention. Our study revealed that DEG-contaminated paracetamol causes unexplained AKI in children. However, paracetamol is not the only contaminated drug. Other drugs, such as cough expectorants, antihistamines, and sedatives, can also be affected. Other chemicals, such as ethylene glycol and propylene glycol, can also contribute to poisonings.
Allergy
New approaches to immunotherapy in house dust mite allergy   (2,526 times)
In Sik Kim
Clin Exp Pediatr. 2023;66(4):161-168.   Published online October 25, 2022
Allergen immunotherapy (AIT) has developed over the last few decades and has emerged as a promising treatment. House dust mite (HDM) is a target allergen in AIT, and various modified HDM allergens have been improved for their efficacy. Moreover, clinical trials have proved their significantly therapeutic effects in allergy. This article review focuses on HDM allergens developed for AIT efficacy,...
General Pediatrics
Metabolic complications of obesity in children and adolescents   (2,479 times)
Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park
Clin Exp Pediatr. 2024;67(7):347-355.   Published online November 16, 2023
· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity.
Infection
Therapeutics for the treatment of coronavirus disease 2019 in children and adolescents   (2,463 times)
Soo-Han Choi, Jae Hong Choi, Ki Wook Yun
Clin Exp Pediatr. 2022;65(8):377-386.   Published online June 27, 2022
· Children and adolescents with high risks for severe coronavirus disease 2019 (COVID-19) should be identified and proper treatment should be provided promptly according to the patient’s condition.
· Remdesivir can be considered for pediatric patients of all ages with COVID-19 who have an emergent or increase in supplemental oxygen.
· The use of corticosteroids is not recommended for patients with nonsevere COVID-19. Corticosteroids are recommended in children and adolescents with severe and critical COVID-19.
COVID-19 in immunocompromised children and adolescents   (2,434 times)
Byung Ok Kwak, Byung Wook Eun
Clin Exp Pediatr. 2023;66(5):182-189.   Published online April 18, 2023
Most immunocompromised children and adolescents are not at increased risk of developing severe coronavirus disease 2019 (COVID-19). COVID-19 outcomes for low- or medium-risk immunocompromised children are favorable, while more serious illness reportedly occurs in high-risk immunocompromised children by underlying disease, its treatments, and other factors. Therefore, the early detection and timely management of severe COVID-19 and treatment of underlying disease are important. Hospitalization and COVID-19 vaccination should be carefully considered.
Original Article
Other
Virtual, augmented, and mixed reality: potential clinical and training applications in pediatrics   (2,425 times)
Suyoung Yoo, Meong Hi Son
Clin Exp Pediatr. 2024;67(2):92-103.   Published online May 24, 2023
· Review of articles that investigated the applications of virtual, augmented, or mixed reality in pediatric clinical settings and in the training of pediatric medical professionals was conducted.
· A total of 89 studies were retrieved, with 36 randomized controlled trials.
· In most studies, intervention using the novel technology was at least as effective or more effective than the traditional method.
· Use of virtual, augmented, and mixed reality has potential in pediatrics.
Review Article
Endocrinology
Nonalcoholic fatty liver disease and insulin resistance in children   (2,421 times)
Kyungchul Song, Ho-Seong Kim, Hyun Wook Chae
Clin Exp Pediatr. 2023;66(12):512-519.   Published online January 9, 2023
· The prevalence of pediatric nonalcoholic fatty liver disease (NAFLD) increased from 8.2% in 2009 to 12.1% in 2018 in Korea.
· Laboratory tests, biomarkers, and imaging studies are used for the early detection of NAFLD.
· Insulin resistance is closely related to NAFLD.
Original Article
Pulmonology
Modified high-flow nasal cannula for children with respiratory distress   (2,417 times)
Sarocha Itdhiamornkulchai, Aroonwan Preutthipan, Jarin Vaewpanich, Nattachai Anantasit
Clin Exp Pediatr. 2022;65(3):136-141.   Published online May 24, 2021
Question: Can the modified high-flow nasal cannula (HFNC) provide alternative respiratory support for children with acute respiratory distress?
Finding: A total of 74 patients were assigned to the modified or commercial HFNC groups. The intubation rate, length of hospital stay, and adverse events did not differ between the 2 groups.
Meaning: The modified HFNC can provide alternative respiratory support for pediatric respiratory distress.
Review Article
Infection
Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review   (2,387 times)
Mohamad Shieb, Rand Hasanain, Zara Arshad, Faisal A. Nawaz, Rahul Kashyap, Eric J. Stern
Clin Exp Pediatr. 2024;67(9):427-434.   Published online April 5, 2024
The overall incidence of bloodstream infections was 23.5%. Gram-negative organisms occur at a much higher rate in pediatric liver transplant recipients then that the general pediatric population. However, when comparing pediatric and adult liver transplant recipients Gram-positive organisms occur with a much higher rate in the pediatric population highlighting the importance of early and broad spectrum antimicrobial coverage when bloodstream infections are suspected.
Developmental and Behavioral Medicine
Clinical practice guidelines for attention-deficit/hyperactivity disorder: recent updates   (2,385 times)
Tae Hoon Eom, Young-Hoon Kim
Clin Exp Pediatr. 2024;67(1):26-34.   Published online June 14, 2023
· 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.
Endocrinology
Association between pre- and postnatal exposure to endocrine-disrupting chemicals and birth and neurodevelopmental outcomes: an extensive review   (2,377 times)
Ozge Yesildemir, Mensure Nur Celik
Clin Exp Pediatr. 2024;67(7):328-346.   Published online November 16, 2023
· Sensitivity to endocrine-disrupting chemical (EDC) exposure increases during critical developmental periods (in embryos, fetuses, and neonates).
· Pre- and postnatal exposure to EDCs is associated with fetal growth restriction, preterm birth, and low birth weight.
· Exposure to EDCs during fetal and early postnatal life can have lasting and lifelong neurodevelopmental outcomes, including autism spectrum, attention deficit hyperactivity, and other cognitive and behavioral disorders.
Allergy
Diagnosis and management of asthma in infants and preschoolers   (2,370 times)
Hai Lee Chung
Clin Exp Pediatr. 2022;65(12):574-584.   Published online April 19, 2022
· Asthma in infants and preschoolers involves heterogeneous phenotypes.
· Asthma diagnosis is based on symptom patterns, therapeutic responses, and the presence of risk factors with careful consideration of differential diagnosis.
· Daily inhaled corticosteroid therapy remains the most effective strategy for managing persistent asthma symptoms irrespective of phenotype.
· Future research, including genetic and molecular studies, is needed to develop a clear definition of asthma and personalized therapeutic approaches.
Editorial
Endocrinology
Bisphenol A leaching from polycarbonate baby bottles into baby food causes potential health issues   (2,312 times)
Ga Won Jeon
Clin Exp Pediatr. 2022;65(9):450-452.   Published online July 25, 2022
Can bisphenol A (BPA) leach out from polycarbonate baby bottles into baby food? BPA and other toxic materials can leach out from baby bottles and increase the risk of various health problems, including endocrine disturbances. Although the use of BPA in baby bottles has been banned, many developing countries still use it, which can cause health issues. Thus, public awareness of this issue is required.
Review Article
Neonatology (Perinatology)
Quantifying myelin in neonates using magnetic resonance imaging: a systematic literature review   (2,266 times)
Nabila Hanem Arshad, Hasyma Abu Hassan, Nur Farhayu Omar, Zurina Zainudin
Clin Exp Pediatr. 2024;67(8):371-385.   Published online December 6, 2023
Question: This systematic review attempts to discover the best magnetic resonance imaging (MRI) technique for myelin quantification in neonates by evaluating various MRI parameters and their reproducibility.
Finding: Since the benefits of using synthetic MRI for quantifying myelin in neonates outweigh the very minor draw- backs, it is recommended.
Meaning: The findings suggest the importance of identifying noninvasive MRI techniques available to assess myelin tissue in neonates, which aid in diagnosing neurodevelopmental disorders.
Letter to the editor
Nephrology (Genitourinary)
Impact of COVID-19 pandemic on healthcare provision in youth with systemic lupus erythematosus   (2,258 times)
Punchita Apisrinitirath, Nuanpan Siripen, Pornpimol Rianthavorn
Clin Exp Pediatr. 2024;67(11):628-631.   Published online October 28, 2024
Review Article
Infection
Epidemiological changes in infectious diseases during the coronavirus disease 2019 pandemic in Korea: a systematic review   (2,238 times)
Jong Gyun Ahn
Clin Exp Pediatr. 2022;65(4):167-171.   Published online November 30, 2021
· Nonpharmaceutical interventions (NPIs) have had a major impact on the epidemiology of various infectious diseases in Korea.
· Respiratory diseases and gastrointestinal viral diseases were significantly reduced during the NPI period.
· The decrease in Kawasaki disease after the introduction of NPI is an unintended result.
· Infectious diseases that decreased during NPI use may re-emerge.
· We must continuously monitor the epidemiology of various infectious diseases during the coronavirus era
Original Article
Pulmonology
Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress   (2,203 times)
Kantara Saelim, Busawan Thirapaleka, Kanokpan Ruangnapa, Pharsai Prasertsan, Wanaporn Anuntaseree
Clin Exp Pediatr. 2022;65(12):595-601.   Published online November 1, 2022
SpO2/FiO2 ratio ≤166, pediatric respiratory rate-oxygenation index <132, and clinical respiratory score ≥6 at 12 hours after high-flow nasal cannula (HFNC) initiation were useful bedside predictors for HFNC failure in pediatric patients.