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"Most viewed" Articles are from the articles published in 2024 during the last six month.

Original Article
Cardiology
Vasovagal syncope and postural orthostatic tachycardia syndrome in adolescents: transcranial doppler versus autonomic function test results   (6,093 times)
Dong Won Lee
Clin Exp Pediatr. 2025;68(9):673-679.   Published online August 6, 2025
Question: Vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) are representative forms of neurally mediated syncope. What influences the occurrence of each?
Finding: Autonomic function test results did not differ, but cerebral blood flow during diastole on transcranial doppler differed between VVS and POTS.
Meaning: Differences in diastolic cerebral blood flow velocity play an important role in VVS and POTS.
Neonatology (Perinatology)
Differential roles of interleukin-6 and adrenomedullin in early diagnosis and mortality predictions in late-onset neonatal sepsis   (6,065 times)
Emilly Henrique dos Santos, Gabriel Acca Barreira, Mariana Okay Saippa, Maria Carolina Pires Cruz, Karen Alessandra Rodrigues, Ronaldo Arkader, Thelma Suely Okay
Clin Exp Pediatr. 2025;68(6):463-471.   Published online December 23, 2024
Question: Can adrenomedullin (ADM) or interleukin-6 (IL-6) detect late-onset neonatal sepsis (LOS) at admission (area under the curve [AUC]>0.90) as an early diagnostic marker?
Finding: Only IL-6 consistently distinguished survivors from nonsurvivors (AUC>0.90) on admission and antibiotic treatment days 3 and 7. C-reactive protein level identified infections from day 3 but failed to predict outcomes (AUC<0.70).
Meaning: IL-6 level can improve LOS diagnosis and prognosis.
Editorial
Other
Beyond the eye: a multidisciplinary perspective on managing pediatric myopia   (6,059 times)
Eoi Jong Seo
Clin Exp Pediatr. 2025;68(8):566-568.   Published online July 18, 2025
Myopia is a growing global public health concern because of its association with irreversible vision loss such as myopic traction maculopathy, rhegmatogenous retinal detachment, and glaucoma. The effective prevention of myopia in childhood requires a multidisciplinary approach that integrates ophthalmologic care with lifestyle, nutrition, and sleep interventions. Early detection through regular visual screening in schools and primary care settings and timely ophthalmology referrals are critical to preventing high myopia.
Original Article
Nutrition
Differential effects of dietary and physical activity interventions on adiposity of children with obesity   (5,982 times)
Anekchoke Tangtongsoong, Chonnikant Visuthranukul, Yuda Chongpison, Sirinuch Chomtho
Clin Exp Pediatr. 2025;68(5):370-378.   Published online February 3, 2025
Question: How do dietary intake and physical activity affect body mass index (BMI) z scores and adiposity among children with obesity?
Finding: Higher dietary protein and fiber intakes were significantly associated with a decrease in BMI z scores and adiposity among children with obesity.
Meaning: Optimizing dietary interventions by focusing on protein and fiber intakes could be an effective strategy for managing childhood obesity.
Review Article
Neonatology (Perinatology)
Strategies to support language development in neonatal intensive care unit: a narrative review   (5,954 times)
Ju Sun Heo, Ee-Kyung Kim
Clin Exp Pediatr. 2024;67(12):651-663.   Published online November 6, 2024
· Preterm infants often experience speech and language development delays during early childhood, impacting children's ultimate outcomes.
· Promoting breastfeeding, increasing parent-infant interactions in a single-family room, promoting a nurturing language environment by parental book reading and language interventions, and parent-integrated interventions in the neonatal intensive care unit could potentially enhance children's language development.
· Integrating these strategies through family-centered care is essential.
Original Article
Critical Care Medicine
Effect of postoperative enteral protein supplementation on nitrogen balance in critically ill children   (5,892 times)
Irene Yuniar, Kadek Apik Lestari, Antonius Hocky Pudjiadi, Fatima Safira Alatas, Yoga Devaera
Clin Exp Pediatr. 2025;68(10):790-800.   Published online May 30, 2025
Question: Does high-protein enteral nutrition better increase the average nitrogen balance (NB) and decrease the intestinal fatty acid-binding protein (I-FABP) level of critically ill postoperative children than standard-protein enteral nutrition?
Finding: The study demonstrated a significant increase in average NB but no significant decrease in I-FABP levels in the high- versus low-protein group.
Meaning: These findings suggest that high-protein enteral nutrition can improve NB in critically ill postoperative children, thereby supporting their recovery.
Gastroenterology
Fecal microbiome profiles in infants with biliary atresia versus nonbiliary atresia cholestasis: a pilot study   (5,889 times)
Nur Azizah, Fadilah Fadilah, Silvia Werdhy Lestari, Muzal Kadim, Fithriyah Sjatha, Hanifah Oswari
Clin Exp Pediatr. 2025;68(11):932-943.   Published online August 20, 2025
Question: How does the gut microbiota profile of infants with biliary atresia (BA) differ from that of infants with non-BA cholestasis and healthy infants in the Indonesian population?
Finding: The unique fecal microbiome composition of the BA group differed significantly from that of the other 2 groups.
Meaning: There is an urgent need to improve dysbiosis in BA and non-BA cholestasis to prevent worsening liver injury in cholestasis.
Efficacy and safety of carbon dioxide versus room-air insufflation in pediatric colonoscopy: a randomized controlled trial   (5,823 times)
Ajay Aravind, Ujjal Poddar, Anshu Srivastava, Moinak Sen Sarma
Clin Exp Pediatr. 2025;68(8):594-600.   Published online March 11, 2025
CO2 insufflation has been used instead of air insufflation to reduce postprocedure pain and discomfort in adults; however, adequately powered studies in children are scarce. This randomized controlled trial of 200 children showed that CO2 insufflation reduces postprocedure pain and discomfort during pediatric colonoscopy with no signs of CO2 retention. CO2 insufflation is safe and causes less pain in children.
Review Article
Nephrology (Genitourinary)
X-linked hypophosphatemic rickets: from diagnosis to management   (5,820 times)
Eujin Park, Hee Gyung Kang
Clin Exp Pediatr. 2024;67(1):17-25.   Published online June 14, 2023
· X-linked hypophosphatemia (XLH), the most common cause of hypophosphatemic rickets, affects 1/20,000 people.
· XLH is caused by a loss-of-function mutation of the PHEX gene.
· Its main pathogenesis is elevated fibroblast growth factor-23 (FGF23) level.
· Burosumab, an FGF23 inhibitor, was developed in the early 2000s.
· Burosumab was approved in Korea in 2020 for XLH patients aged 1+ years with radiographic evidence of bone disease.
Gastroenterology
Value of transabdominal ultrasonography for diagnosing functional constipation in children: a systematic review and meta-analysis   (5,790 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...
Allergy
Moderate to severe atopic dermatitis in children: focus on systemic Th2 cytokine receptor antagonists and Janus kinase inhibitors   (5,751 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.
Gastroenterology
Neonatal ichthyosis-sclerosing cholangitis syndrome caused by a novel CLDN1 mutation: a case report and literature review   (5,721 times)
Upasana Ghosh, Ankit Agrawal, Varunvenkat M. Srinivasan, Rani Manisha, Umesh Shukla, Vikas Jain, Mayank Nilay, Harish Kumar
Clin Exp Pediatr. 2025;68(11):858-867.   Published online October 2, 2025
· Neonatal ichthyosis-sclerosing cholangitis (NISCH) syndrome is a rare autosomal recessive disorder characterized by cholestasis and manifestations such as generalized ichthyosis, alopecia, and dental anomalies.
· The clinical features of NISCH syndrome are distinct and necessitate an early genetic diagnosis.
· The disease phenotype can vary significantly, ranging from no liver involvement and transient neonatal cholestasis to end-stage liver disease.
· Management requires a multidisciplinary approach with long-term follow-up.
Endocrinology
Continuous glucose monitoring in Korean pediatric patients with type 1 diabetes: current landscape and clinical implications   (5,663 times)
Hwa Young Kim, Jaehyun Kim
Clin Exp Pediatr. 2025;68(11):842-851.   Published online October 2, 2025
Continuous glucose monitoring (CGM) has transformed pediatric type 1 diabetes care by facilitating tighter glycemic control, reducing hypoglycemia, and improving quality of life.
Recent advances in CGM technology and the expansion of insurance coverage in Korea have led to its broader adoption.
Emerging metrics such as time in tight range offer refined tools for individualized glycemic assessment, highlighting CGM’s evolving role in personalized pediatric diabetes management.
Original Article
General Pediatrics
Effect of online infant care training and postpartum counseling based on Meleis' transition theory on mothers' readiness for care and breastfeeding: a randomized controlled trial   (5,646 times)
Fatma Şule Bilgiç, Gülçin Bozkurt
Clin Exp Pediatr. 2024;67(10):521-530.   Published online September 27, 2024
Question: Do interventions based on Meleis' transition theory affect mothers' readiness for baby care and breastfeeding?
Findings: We found a statistically significant difference between the intervention and control groups in mothers' readiness for newborn care and breastfeeding (P<0.001).
Meaning: This intervention increased breastfeeding rates while ensuring that mothers were ready to care for their babies and prepared for the role of motherhood.
Review Article
Gastroenterology
High-resolution anorectal manometry in children   (5,495 times)
Yogesh Waikar
Clin Exp Pediatr. 2024;67(2):57-63.   Published online June 14, 2023
· Anorectal manometry is safe in children.
· Defecation Dyssynergia is one of the commonest cause of chronic constipation.
· Positive Rectoanal inhibiory reflex rules out Hirschsprung's Disease
Original Article
Hematology
Evaluation of Bak and Bcl-Xl gene expression among pediatric patients with acute primary immune thrombocytopenia   (5,440 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.
General Pediatrics
Bifidobacterium animalis subsp. lactis BLa80 for preventing allergic, respiratory, and gastrointestinal diseases in young children in China: a randomized double-blind placebo-controlled trial   (5,428 times)
Ke Chen, Xi Zhang, Kaihong Zeng, Jiayi Zhong, Shanshan Jin, Yang Nie, Ping Yang, Nianyang He, Haixia Chen, Yanmei Cao, Yunrong Fu, Ziji Fang, Wei Jiang, Changqi Lium
Clin Exp Pediatr. 2026;69(2):150-162.   Published online October 30, 2025
Question: Can probiotic BLa80 bring long-term benefits to the health of young children?
Finding: This trial demonstrated that the daily administration of s BLa80 at 5×109 colony-forming units for 3 months in children can reduce the risk of eczema, upper respiratory tract infections, and acute tracheitis/bronchitis as well as beneficially improve the gut microbiome without any adverse effect.
Meaning: Bla80 can bring definite health benefits to young children.
Gastroenterology
Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study   (5,388 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.
Review Article
General Pediatrics
Protecting our future: environmental hazards and children’s health in the face of environmental threats: a comprehensive overview   (5,381 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.
Rheumatology
Double-negative T cells in pediatric rheumatic diseases   (5,362 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.
Endocrinology
Lifelong medical challenges and immunogenetics of Turner syndrome   (5,244 times)
Won Kyoung Cho
Clin Exp Pediatr. 2024;67(11):560-568.   Published online July 31, 2024
· This summary emphasizes the importance of the early diagnosis of Turner syndrome (TS) and presents a multidisciplinary approach to its prevention and management, high-lighting the need for customized care.
· Advancements in immunogenetic research may improve our understanding of TS and improve its outcomes.
· TS encompasses a wide array of medical challenges, including cardiovascular, endocrine, autoimmune, and mental health issues, as well as a heightened cancer risk.
Original Article
Gastroenterology
Dual-strain probiotics Bifidobacterium bifidum and Lactobacillus acidophilus reverse gut dysbiosis in preterm neonates: a randomized controlled trial   (5,179 times)
Setthawut Sittiwong, Pornthep Tanpowpong, Pisut Pongchaikul, Pracha Nuntnarumit
Clin Exp Pediatr. 2025;68(10):763-771.   Published online August 6, 2025
Question: Can probiotics BB/LA reverse gut dysbiosis in preterm neonates?
Finding: BB/LA supplementation induced more diverse beta diversity and increased relative abundances of Bifidobacterium, Lactobacillus and decreased relative abundance Clostridium.
Meaning: Early BB/LA supplementation could reverse gut dysbiosis in preterm neonates.
Endocrinology
Efficacy of leuprolide acetate versus triptorelin pamoate administered every 3 months for treatment of central precocious puberty   (5,000 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.
Neonatology (Perinatology)
Less invasive surfactant administration versus intubation-surfactant-extubation: a single-center retrospective study   (4,979 times)
C.S. Jithin, A. Nalina, A. Shashidhar, P.N. Suman Rao
Clin Exp Pediatr. 2025;68(12):991-997.   Published online October 2, 2025
Question: Does less invasive surfactant administration (LISA) (vs. intubation-surfactant-extubation) improve clinical outcomes in preterm infants with respiratory distress syndrome?
Finding: LISA significantly reduced intubation and invasive mechanical ventilation needs within the first 72 hours and shortened the overall invasive respiratory support duration without increasing other morbidities.
Meaning: LISA is a less invasive and safer surfactant delivery alternative. Larger multicenter trials are needed to confirm its long-term safety and efficacy, especially in low- and middle-income countries.
Editorial
Endocrinology
Rickets prevalence and treatment outcome: real-world data from Taiwan   (4,918 times)
Young Suk Shim
Clin Exp Pediatr. 2025;68(11):868-870.   Published online October 23, 2025
Rickets should be recognized as a significant public health concern during infancy and childhood. Recent studies from Taiwan have demonstrated a steady increase in the prevalence of nutritional rickets, and a similar trend is likely to emerge in Korea. Therefore, comprehensive clinical evaluation and appropriate biochemical assessment are essential to prevent long-term skeletal and systemic complications. Prompt diagnosis and timely initiation of appropriate treatment are crucial.
Original Article
Gastroenterology
Differences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing   (4,896 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.
Infection
Clinical characteristics and associated factors of pediatric acute necrotizing encephalopathy: a retrospective study   (4,841 times)
Huiling Zhang, Yilong Wang, Qianyun Ding, Xuekun Li, Sheng Ye
Clin Exp Pediatr. 2025;68(2):153-162.   Published online November 11, 2024
· The mortality rate of acute necrotizing encephalopathy was high.
· Laboratory tests revealed that the fatal group had higher creatinine, lactate, activated partial thromboplastin time, thrombin time, interleukin (IL)-6, IL-10, creatine kinase, and D-dimer than survivors.
· The fatal group displayed lower Glasgow Coma Scale scores and arterial pH.
Review Article
Allergy
Eosinophil-derived neurotoxin levels can predict allergic disease development and atopic march in children   (4,830 times)
Zak Callaway, Chang-Keun Kim
Clin Exp Pediatr. 2025;68(6):398-405.   Published online February 3, 2025
· Allergic march occurs in a subset of children, beginning with atopic dermatitis and progressing to food allergies, allergic rhinitis, and/or asthma. Its early diagnosis is important to slowing its progression.
· Eosinophil-derived neurotoxin (EDN), an excellent biomarker of eosinophil activity, is often elevated in allergic diseases.
· EDN levels have been used to predict allergic disease development and diagnose, treat, and monitor allergic diseases.
Original Article
Hematology
Hematopoietic stem cell transplantation in pediatric patients with type VI mucopolysaccharidosis   (4,805 times)
Vedat Uygun, Koray Yalçın, Hayriye Daloğlu, Seda Öztürkmen, Suna Çelen, Suleimen Zhumatayev, Gülsün Karasu, Akif Yeşilipek
Clin Exp Pediatr. 2025;68(8):601-607.   Published online March 11, 2025
Question: Could hematopoietic stem cell transplantation (HSCT) be an alternative to enzyme replacement therapy (ERT) for type VI mucopolysaccharidosis (MPS VI)?
Finding: HSCT is generally not offered due to reports of high toxicity and mortality. However, we detected fewer complications and graft-versus-host disease cases and no deaths with HSCT.
Meaning: HSCT is both less expensive than ERT and permanent; thus, it should be considered an alternative treatment for MPS VI.
Pulmonology
Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children?   (4,765 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.


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