Clinical and Experimental Pediatrics

Original Article

Gastroenterology

Risk factors of prolonged diarrhea in children under 2 years old (1,834 times)

Dedy Rahmat, Agus Firmansyah, Ina S. Timan, Saptawati Bardosono, Joedo Prihartono, Pramita Gayatri

Clin Exp Pediatr. 2023;66(12):538-544. Published online November 16, 2023

Question: What are the risk factors for prolonged diarrhea in children under 2 years old?
Finding: History of antibiotic use, zinc deficiency, and elevated fecal alpha-1 antitrypsin levels were the main risk factors of prolonged diarrhea in children under 2 years old with acute diarrhea.
Meaning: Rational antibiotic usage is necessary as well as thorough testing of serum zinc level and fecal alpha-1 antitrypsin levels.

DOI: https://doi.org/10.3345/cep.2023.00668

Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome (1,825 times)

Ozlem Kara, Hanife Aysegul Arsoy, Murat Keskin

Clin Exp Pediatr. 2023;66(9):395-402. Published online June 14, 2023

Web of Science 5 Crossref 4

Question: Is polycystic ovary syndrome (PCOS) a risk factor for nonalcoholic fatty liver disease (NAFLD) in adolescents?
Finding: The frequency of NAFLD did not increase in adolescents with PCOS. However, hyperandrogenemia was a risk factor for NAFLD.
Meaning: Adolescents with PCOS and hyperandrogenemia should be closely monitored for hepatic steatosis.

DOI: https://doi.org/10.3345/cep.2023.00353

Developmental and Behavioral Medicine

Parenting stress and interactive engagement behaviors in children with developmental delay (1,818 times)

Jung Sook Yeom, Rock Bum Kim, Jae Young Cho, Ji Sook Park, Eun Sil Park, Ji-Hyun Seo, Jae-Young Lim, Hyang-Ok Woo

Clin Exp Pediatr. 2023;66(6):252-261. Published online May 19, 2023

Web of Science 1 Crossref 1

· Question: What level of parenting stress is experienced by parents of children with developmental delays (DDs) without autism spectrum disorder, and what factors contribute to it?
· Findings: Parents of children with DDs experienced high parenting stress that were significantly mediated by their children’s low interactive behaviors.
· Meaning: The interactive behaviors of children with DDs mediate parenting stress.

DOI: https://doi.org/10.3345/cep.2023.00101

Review Article

Other

Global trends in importance of 24-hour movement behaviors to pediatric health: implications for South Korea (1,817 times)

Eun-Young Lee, Reyana Jayawardena, Seiyeong Park, Justin Y Jeon, Yeon-Soo Kim, Mark S. Tremblay

Clin Exp Pediatr. 2025;68(1):16-29. Published online November 11, 2024

· The 24-hour movement behavior paradigm provides an important framework for future pediatric health promotion efforts.
· Policy priorities should include advancing surveillance and monitoring assessments related to 24-hour movement behaviors, evaluating their implementation in school and government policies, and building preparedness for future pandemics and natural disasters, including climate change, by promoting healthy 24-hour movement behaviors.
· Future research should advocate for the promotion of 24- hour movement behaviors.

DOI: https://doi.org/10.3345/cep.2024.00178

Neonatology (Perinatology)

Influence of infant microbiome on health and development (1,812 times)

Noelle Younge

Clin Exp Pediatr. 2024;67(5):224-231. Published online August 21, 2023

Web of Science 1 Crossref 2

· The infant gut microbiome is highly dynamic and individualized.
· Microbes are vertically transmitted from mother to infant during delivery and throughout infancy.
· Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function.
· In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems.
· Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality.

DOI: https://doi.org/10.3345/cep.2023.00598

Infection

COVID-19 in immunocompromised children and adolescents (1,811 times)

Byung Ok Kwak, Byung Wook Eun

Clin Exp Pediatr. 2023;66(5):182-189. Published online April 18, 2023

Web of Science 8 Crossref 10

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.

DOI: https://doi.org/10.3345/cep.2022.00878

Nutrition

Protein substitutions as new-generation pharmanutrition approach to managing phenylketonuria (1,810 times)

Fatma Nur Keskin, Teslime Özge Şahin, Raffaele Capasso, Duygu Ağagündüz

Clin Exp Pediatr. 2023;66(8):320-331. Published online November 1, 2022

Web of Science 1 Crossref 1

Phenylketonuria, an autosomal recessive disease that results from the inability to metabolize phenylalanine, is currently treated with medical nutrition therapy. New treatment approaches such as tetrahydrobiopterin, glycomacropeptide, large neutral amino acids, pegvaliase, and gene therapy significantly impact disease management and dietary enrichment. This article also reviews animal and human studies that have evaluated the efficacy and safety of these new protein substitutes.

DOI: https://doi.org/10.3345/cep.2022.00584

Original Article

Developmental and Behavioral Medicine

Neonatal risk factors associated with attention-deficit/hyperactivity disorder: an umbrella review (1,795 times)

Ensiyeh Jenabi, Erfan Ayubi, Sajjad Farashi, Saeid Bashirian, Fereshteh Mehri

Clin Exp Pediatr. 2023;66(10):441-446. Published online July 14, 2023

Web of Science 1 Crossref 1

Question: The risk factors for attention deficit hyperactivity disorder (ADHD), such as breastfeeding, congenital heart disease, and low birth weight, in neonates are not well understood.
Finding: This umbrella review obtained significant effect sizes for ADHD for congenital heart disease (odds ratio [OR], 3.04), low birth weight (OR, 2.25), never breastfed (OR, 1.55), and Apgar score (OR, 1.30).
Meaning: Congenital heart disease, low birth weight, lack of breastfeeding, and Apgar scores were significant factors for ADHD.

DOI: https://doi.org/10.3345/cep.2022.01396

Review Article

Immunology

Systemic autoinflammatory disorders (1,779 times)

Dae Chul Jeong

Clin Exp Pediatr. 2023;66(10):432-438. Published online June 14, 2023

Web of Science 4 Crossref 5

· Systemic autoinflammatory disorders (SAID) are disorders caused by dysregulation of the innate immunity with genetic background, leading to recurrent episodes of systemic inflammation.
· SAID is characterized by recurrent acute inflammatory responses including fever or skin manifestations, unrelated with infection or malignancy.
· Diagnosis is based on family and long-term history with detailed clinical and laboratory manifestations during febrile periods.

DOI: https://doi.org/10.3345/cep.2022.01186

Original Article

Pulmonology

Polysomnographic features of children with obesity: body mass index predict severe obstructive sleep apnea in obese children? (1,777 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.

DOI: https://doi.org/10.3345/cep.2024.00066

Neonatology (Perinatology)

Short-term outcomes of oropharyngeal administration of colostrum in preterm neonates: a double-blind placebocontrolled randomized trial (1,761 times)

Ameneh Lamsehchi, Maryam Shokouhi Solgi, Mohammad Kazem Sabzehei, Behnaz Basiri, Elahe Talebi Ghane, Kiana Kimiaei Asadi, Sina Azadnajafabad

Clin Exp Pediatr. 2025;68(1):73-79. Published online October 31, 2024

Question: What are the short-term outcomes of oropharyngeal administration of colostrum (OAC) in preterm neonates?
Finding: This study demonstrated the significantly lower rates of necrotizing enterocolitis, clinically suspected sepsis, shorter hospital stay, period to full enteral feeding, and antibiotic therapy period in the OAC group.
Meaning: This trial may further expand the clinical application of OAC in premature infants to reduce their length of hospital stay and complications.

DOI: https://doi.org/10.3345/cep.2024.00591

Review Article

Gastroenterology

High-resolution esophageal manometry in children (1,731 times)

Yogesh Waikar

Clin Exp Pediatr. 2023;66(4):155-160. Published online October 17, 2022

Web of Science 2 Crossref 2

High-resolution esophageal manometry can be safely performed in children where recurrent vomiting and persistent dysphagia is the working diagnosis after excluding nonluminal and structural obstructive pathologies using pediatric upper gastrointestinal endoscopy. Normal manometry values are available. Clinical picture, biochemical tests, radiological interpretation, and endoscopic findings with manometry completes the analysis of patients with recurrent vomiting and dysphagia.

DOI: https://doi.org/10.3345/cep.2022.00787

Editorial

Immunology

Utility of eosinophil granule proteins in management of pediatric chronic cough (1,726 times)

Chang-Keun Kim

Clin Exp Pediatr. 2024;67(10):519-520. Published online April 17, 2024

· Pediatric chronic cough often involves eosinophilic inflammation; however, objective measurements are not routinely used in treatment decisions.
· Accurate biomarkers of eosinophil activity, such as eosinophil-derived neurotoxin (EDN) and cationic proteins (ECP), should be used. EDN, which overcomes the shortcomings of ECP, recently received approval for use in Korean healthcare settings.
· EDN and ECP can play a role in treatment period and drug selection decisions.

DOI: https://doi.org/10.3345/cep.2023.01431

Review Article

Allergy

Action-plan and as-needed therapy in allergic rhinitis (1,716 times)

Hyeon-Jong Yang

Clin Exp Pediatr. 2024;67(6):267-273. Published online May 21, 2024

Web of Science 2 Crossref 2

· The guidelines may not work in the real world.
· An action-plan reflecting patient’s severity and variable of symptoms, values and preferences as well as the benefits and harms of treatment, may be a useful alternative.
· The action plan and as-needed therapy must include the following elements: when, what, how, and why.
· Action plan and as-needed therapy can help patients manage their symptoms more effectively.

DOI: https://doi.org/10.3345/cep.2023.00654

Original Article

Genetics and Metabolism

Interleukin (IL)-1B and IL-1 receptor antagonist gene polymorphisms in children with primary immune thrombocytopenia (1,690 times)

Seham Mohamed Ragab, Wafaa Moustafa Abo ElFotoh, Mahmoud Ahmed El-Hawy, Eman Abdelfatah Badr, Saara Khairat Ali Mostafa, Mai El-Sayad Abd El-Hamid

Clin Exp Pediatr. 2024;67(9):465-473. Published online July 24, 2024

· Polymorphisms in interleukin (IL)-1B and IL-1 receptor (IL-1R) antagonists may significantly affect the pathogenesis of immune thrombocytopenia (ITP).
· IL-1B and IL-1R antagonist gene polymorphisms are correlated with severity and susceptibility to primary ITP in children.

DOI: https://doi.org/10.3345/cep.2024.00577

Developmental and Behavioral Medicine

Attention-deficit/hyperactive-impulsive disorder symptoms among grade 1 students with reading disorder in Thailand (1,671 times)

Patcharapun Sarisuta, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho

Clin Exp Pediatr. 2023;66(11):485-492. Published online October 24, 2023

Crossref 2

Question: Would students with reading disorder have a significantly higher prevalence of attention-deficit/hyperactiveimpulsive disorder (ADHD) symptoms than neurotypical students?
Finding: Students at risk of reading disorder exhibited significant ADHD symptoms compared with those not at risk of reading disorder according to all presentations of teacher assessments versus only for predominantly inattentive presentations of the parental assessments.
Meaning: Students with reading disorder have a significantly higher prevalence of ADHD symptoms than neurotypical students. Sex, parental education level, average family income, and children’s school affiliation significantly influenced reading disorder prevalence.

DOI: https://doi.org/10.3345/cep.2023.00773

General Pediatrics

Role of proper postnatal care in continued exclusive breastfeeding among young Indonesian mothers (1,665 times)

Wahyu Triadmajani, Shinta Prawitasari, Abdul Wahab

Clin Exp Pediatr. 2024;67(12):686-693. Published online September 12, 2024

Question: Is proper postnatal care (PNC) associated with exclusive breastfeeding (EBF) practice among young Indonesian mothers?
Finding: Proper PNC elevates the likelihood of EBF among Indonesian adolescent mothers aged 15–19 years.
Meaning: Breastfeeding services should be provided during the early postnatal period to support EBF practice among adolescent mothers. High-quality PNC is a tailored intervention for vulnerable populations.

DOI: https://doi.org/10.3345/cep.2024.00815

Review Article

Neonatology (Perinatology)

Quantifying myelin in neonates using magnetic resonance imaging: a systematic literature review (1,663 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.

DOI: https://doi.org/10.3345/cep.2023.00514

Editorial

Immunology

Systemic autoinflammatory disorders: autoinflammatory and autoimmune disorders (1,659 times)

Young Dae Kim

Clin Exp Pediatr. 2023;66(10):439-440. Published online July 4, 2023

Web of Science 4 Crossref 4

· Systemic autoinflammatory disorders (SAIDs) typically have an early onset in life, and may have close relatives may have similar disease.
· SAIDs should be suspected in any patient, especially children, who experience persistent or recurrent inflammatory episodes that fail to fit the pattern of other established diseases.
· Advancements in the understanding of autoinflammation will provide novel diagnostic and therapeutic options for SAIDs patients.

DOI: https://doi.org/10.3345/cep.2023.00605

Review Article

Allergy

Practical issues of oral immunotherapy for egg or milk allergy (1,657 times)

Sukyung Kim, Kangmo Ahn, Jihyun Kim

Clin Exp Pediatr. 2024;67(3):140-148. Published online June 19, 2023

Web of Science 2 Crossref 1

· Oral immunotherapy should be supervised by pediatricians with experience administering oral food challenge tests and managing allergic reactions.
· Food allergen intake is gradually increased and maintained for years.
· Patients may experience allergic reactions and psychological problems.
· Adjunctive therapies (biologics, antihistamines, and leukotriene receptor antagonists) may improve efficacy and safety.
· Contraindications include uncontrolled asthma, malignancy, active autoimmune disorders, and beta-blocker usage.

DOI: https://doi.org/10.3345/cep.2023.00234

Editorial

Endocrinology

Nonalcoholic fatty liver disease in children and adolescents (1,657 times)

Hae Sang Lee

Clin Exp Pediatr. 2024;67(2):90-91. Published online January 24, 2024

Web of Science 2 Crossref 2

· With the increase in childhood obesity, nonalcoholic fatty liver disease (NAFLD) has become a concern in recent years.
· NAFLD is strongly associated with insulin resistance.
· Lifestyle modifications are the mainstay treatment for NAFLD.

DOI: https://doi.org/10.3345/cep.2023.00752

Original Article

Cardiology

Echocardiographic reference z scores of right ventricular dimension and systolic function of children aged 5–12 years (1,635 times)

Alaba Busola Oladimeji, Moriam Omolola Lamina, Peter Odion Ubuane, Motunrayo Oluwabukola Adekunle, Omolara Adeolu Kehinde, Barakat Adeola Animasahun, Olisamedua FidelisNjokanma

Clin Exp Pediatr. 2023;66(5):215-222. Published online April 18, 2023

Question: Z score reference values for right ventricular size and systolic function in children using echocardiography are available in several countries. Despite the high burden of diseases involving the right ventricle in Nigeria, these reference values have limited applicability.
Finding: The right ventricular sizes of Nigerian children differed from those published elsewhere.
Meaning: These reference values will aid the treatment, monitoring, and pre- and postintervention for Nigerian children.

DOI: https://doi.org/10.3345/cep.2022.01410

Perspective

Other

New public-centered child protection system in Korea (1,628 times)

We Sun Shim

Clin Exp Pediatr. 2023;66(5):179-181. Published online April 18, 2023

Web of Science 1 Crossref 1

Korea’s child abuse response system was transformed under policy change in April 2020, from what was previously operated on a private-centered basis to a focus on the public sector with expanded role of local governments. Promising outcomes are expected with new system as greater governmental intervention will effectively protect at-risk children with acceleration in institutional collaboration and expertise in information management and administration.

DOI: https://doi.org/10.3345/cep.2023.00150

Original Article

Cardiology

Comparative analysis of adolescent hypertension definitions for predicting early adulthood carotid artery intima-media thickness: Tehran lipid and glucose study (1,621 times)

Maryam Barzin, Shirin Yaghoobpoor, Maryam Mahdavi, Behnaz Abiri, Majid Valizadeh, Fereidoun Azizi, Pooneh Dehghan, Farhad Hosseinpanah

Clin Exp Pediatr. 2024;67(12):694-703. Published online September 12, 2024

Crossref 1

Question: What is the prevalence of HTN among adolescents enrolled in the TLGS according to 3 different accepted definitions (4th report, ESH, and AAP-CPG). Also, what is the ability of each of these definitions in predicting early adulthood CIMT, as a surrogate for cardiovascular disease events?
Finding: The highest and lowest prevalence of stage 1 HTN was observed with the AAP-CPG (17.7%) and ESH (8.8%), respectively. Similarly, the highest and lowest prevalence of stage 2 HTN was noted with the AAP-CPG (1.5%) and ESH (0.8%), respectively. The highest to lowest predictive abilities belonged to the 4th report, ESH, and AAP-CPG, respectively.
Meaning: Among the various definitions of pediatric HTN, the 4th report offered the best ability to predict a high CIMT during early adulthood, followed by the ESH and AAP-CPG.

DOI: https://doi.org/10.3345/cep.2024.00248

Review Article

Endocrinology

Lifelong medical challenges and immunogenetics of Turner syndrome (1,613 times)

Won Kyoung Cho

Clin Exp Pediatr. 2024;67(11):560-568. Published online July 31, 2024

Web of Science 2 Crossref 2

· 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.

DOI: https://doi.org/10.3345/cep.2024.00430

Original Article

Developmental and Behavioral Medicine

Characteristics of temper tantrums in 1–6-year-old children and impact on caregivers (1,606 times)

Warangkana Prutipaisan, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho

Clin Exp Pediatr. 2025;68(2):170-177. Published online November 13, 2024

Question: What are common tantrum behaviors in preschool children, and how frequently are problematic behaviors observed? Do problematic tantrums have a different emotional impact on caregivers compared to typical tantrums?
Finding: Temper tantrums are common in preschool children, and verbal tantrums are the most common type.
Meaning: Problematic tantrums, defined as tantrums exhibiting aggressive physical behavior, long duration (>15 minutes), or frequent occurrence (>3 days/wk), significantly affected caregivers’ emotions.

DOI: https://doi.org/10.3345/cep.2024.00766

Neonatology (Perinatology)

Mortality of very low birth weight infants by neonatal intensive care unit workload and regional group status (1,605 times)

Sung-Hoon Chung, Chae Young Kim, Yong-Sung Choi, Myung Hee Lee, Jae Woo Lim, Byong Sop Lee, Ki-Soo Kim; the Korean Neonatal Network

Clin Exp Pediatr. 2024;67(11):619-627. Published online September 12, 2024

Question: How do structural and staffing characteristics of neonatal intensive care units (NICUs) influence the mortality rates of very low birth weight infants (VLBWIs)?
Findings: NICUs with higher staffing levels, particularly with more neonatologists, and those offering advanced care levels were associated with lower mortality rates. Additionally, regional disparities were observed, with some areas demon-strating significantly higher survival rates.
Meaning: Adequate staffing and equitable regional distribution of medical resources are crucial for improving survival outcomes in VLBWIs. Efforts to enhance NICU staffing and address regional healthcare disparities are essential for optimizing care quality and reducing mortality in this vulnerable population.

DOI: https://doi.org/10.3345/cep.2023.01613

Letter to the Editor

Endocrinology

Accuracy of predicted adult height using the Greulich-Pyle method and artificial intelligence medical device (1,601 times)

Dongho Cho, Yun Sun Choi, Hayun Oh, Young min Ahn, Ji-Young Seo

Clin Exp Pediatr. 2023;66(3):145-147. Published online January 25, 2023

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2022.01116

Original Article

Endocrinology

Kisspeptin and DLK1 levels for monitoring treatment of girls with central precocious puberty (1,596 times)

Witchuwan Onsoi, Nattakarn Numsriskulrat, Suphab Aroonparkmongkol, Vichit Supornsilchai, Khomsak Srilanchakon

Clin Exp Pediatr. 2024;67(6):296-302. Published online May 21, 2024

Web of Science 2 Crossref 3

Questions: Can the serum levels of kisspeptin and DLK1 be potential biomarkers for monitoring the treatments for central precocious puberty (CPP)?
Findings: There were no significant differences in the baseline serum kisspeptin and DLK1 levels in CPP girls compared to girls with premature thelarche (PT). After 6 months of GnRH analogue treatment in CPP girls, median serum kisspeptin levels decreased, while median serum DLK1 levels increased compared to baseline.
Meanings: Serum levels of kisspeptin and DLK1 may serve as novel biomarkers for monitoring the efficacy of treatments for CPP.

DOI: https://doi.org/10.3345/cep.2023.01361

General Pediatrics

Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia (1,594 times)

Abdul Wahab, Ida Safitri Laksanawati, Retna Siwi Padmawati, Asal Wahyuni Erlin Mulyadi, Wahyu Triadmajani, Jarir At Thobari

Clin Exp Pediatr. 2025;68(3):228-237. Published online November 13, 2024

Crossref 1

Question: Do community members and health providers show different level of knowledge, attitude, and practice towards dengue vaccine?
Finding: These 2 groups only differed in practice component, while the knowledge and attitude constituents were relatively low for both.
Meaning: There is an urgent need to deliver educational interventions to raise awareness of community members and health providers regarding dengue vaccination.

DOI: https://doi.org/10.3345/cep.2024.00962

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