· The safety and efficacy of the two-bag versus one-bag system for treating patients with diabetic ketoacidosis (DKA) < 21 years remains unestablished. · Our meta-analysis demonstrated similar safety outcomes but sooner DKA resolution and shorter mean response time for intravenous fluid changes for the two-bag system. · This preliminary evidence suggests that the two-bag system has some advantages in efficacy, but further studies are needed to evaluate their extent. |
Question: Does paternal support affect exclusive breastfeeding failure? Finding: Exclusive breastfeeding failure by 3 months was affected by paternal support. Meaning: Fathers should be included in breastfeeding education and antenatal care. |
· A detailed history and comprehensive physical examination remain the cornerstones for establishing a diagnosis of global developmental delay/intellectual disability (GDD/ID). · Comprehensive surveillance and screening programs play a significant role in the early detection of GDD. · Whole-exome sequencing is highly recommended as first- or second-line testing for individuals with idiopathic GDD/ID. · Early intervention by a well-versed multidisciplinary team can significantly improve the outcomes and prognosis of GDD/ID. |
Question: Does online responsive teaching (RT) impact children's and parents’ emotions and behaviors, and do parents find it satisfactory? Finding: Online RT significantly improved children's pivotal and problem behaviors, decreased parenting stress, and enhanced parental interactive styles with high satisfaction. Meaning: This pilot study's findings suggest that online RT can enhance child outcomes, offering accessible interventions amid challenges such as limited access and pandemics. |
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. |
· Plagiocephaly is characterized by the asymmetrical shape of a baby’s head. · Since positional plagiocephaly is associated with developmental delay and further musculoskeletal problems, early detection allows for timely intervention and prevents worsening of the condition. · Pediatricians can educate parents about proper head positioning and encourage supervised tummy time during awake hours. |
· Iron deficiency has important effects on neurodevelopment and the immune system in children. · Hepcidine plays an important role in iron homeostasis. · Diagnosis and treatment of iron deficiency in chronic inflammatory disease are important for patients' quality of life and disease course. |
· Virtual reality (VR) is becoming increasingly common for entertainment and in medical settings. · VR is useful for treating children with cerebral palsy. · VR can help with attention deficit/hyperactivity disorder symptoms. · VR can decrease pain perception in children undergoing burn wound care. · VR can reduce preoperative anxiety. · VR can reduce fear and pain during needle-involving procedures. |
· 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. |
Liver transplantation (LT) is crucial for children with end-stage liver diseases, yet bloodstream infections (BSI) pose significant risks, despite medical advancements. Immunosuppressants, essential for preventing organ rejection, heighten infection susceptibility. Understanding BSI organisms is vital due to antimicrobial resistance. Pediatric LT recipients have unique risk factors, demanding tailored preventive measures. This systematic review on bacterial BSI emphasizes the urgency of effective prevention strategies, considering the high incidence and distinct organism profile. Further research is vital for optimizing antibiotic management and improving outcomes for this vulnerable population. |
· 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. |
Question: Is bronchopulmonary dysplasia (BPD) associated with functional/structural abnormalities later in life? Finding: School-aged children with severe BPD had abnormalities on pulmonary function tests and lung computed tomography despite no subjective respiratory symptoms; however, only prenatal oligohydramnios and prolonged ventilator use were associated with abnormal lung function. Meaning: Long-term monitoring of preterm infants’ lung health is essential, especially for those with prenatal oligohydramnios or prolonged ventilator use. |
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. |
Question: Is vitamin E a viable therapeutic option for managing neonatal hyperbilirubinemia? Finding: This randomized clinical trial examined the effects of oral vitamin E supplementation on bilirubin reduction (primary outcome), phototherapy duration, and length of hospital stay (secondary outcome) in 138 infants. Meaning: Infants administered vitamin E versus placebo demonstrated similar reductions in bilirubin levels and length of hospital stay. |
· The frequency of benign convulsions with mild gastroenteritis (CwG) was not significantly influenced by the pandemic. · The coronavirus disease 2019 pandemic has further diversified the etiologic enteric viral pathogens of CwG. |
Question: Did coronavirus disease 2019 (COVID-19) affect the frequency, seasonal variation, or virus type of benign convulsions with mild gastroenteritis (CwG)? Findings: We compared 41 cases of CwG before and during the COVID-19 pandemic. After March 2020, frequency did not change significantly (18 patients vs. 23 patients), seasonal variation was lost, and number of cases of enteric adenovirus-associated CwG increased (1 cases vs. 7 cases). Meaning: The COVID-19 pandemic affected CwG. |
Question: Does zinc supplementation along with probiotics affect disease severity or clinical outcomes of children with acute diarrhea? Findings: This study indicated that zinc supplementation and probiotics had no effect on clinical improvement or disease severity among pediatric patients with acute diarrhea. Meaning: Children who received probiotics plus zinc recovered faster than those who received probiotics only. |
Question: What is the optimal dose of bone marrow-derived mesenchymal stem cells (BM-MSCs) for treating necrotizing enterocolitis (NEC), and is orally administered BM-MSC effective? Findings: High (1×106 cells) or multiple BM-MSC doses showed similar effects as low (1×105 cells) doses of intraperitoneally administered BM-MSCs. Furthermore, orally administered BM-MSCs were as effective as intraperitoneally administered BM-MSCs. Meaning: Orally administered low-dose BM-MSCs are a potential treatment for NEC. |
· Patients with neurological diseases often require external mechanical support to maintain mechanical ventilation or supply. · Little has been done to help the families of affected children make difficult decisions that carry significant physical and psychological consequences. · The establishment of a department that provides pediatric palliative care for neurological patients should be considered. |
· 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. |
· 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). |
Question: Can face masks alter pulmonary pressure in children and adolescents with and without congenital heart disease? Findings: Mask removal during echocardiography (ECHO) reduced pulmonary pressure. Meaning: These findings suggest that face masks should be removed during ECHO in children and adolescents. |
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. |
· Laryngeal masks (LMs) offer stable airway access and skill retention advantages, making them promising alternatives to positive-pressure ventilation in neonatal care. · The ease of teaching LM insertion techniques to less experienced providers addresses the need for swift intervention and skill retention. · Careful consideration of the benefits and challenges of LMs is essential in determining their effective integration into enhanced neonatal resuscitation protocols. |
Newborns born to mothers infected with coronavirus disease 2019 (COVID-19) should be closely monitored for respiratory disorders, such as transient tachypnea of the newborn, regardless of their COVID-19 test results. Further research is required of the development of infants born to mothers with COVID-19. The trends in Korea's birth rate and infant mortality rates have not been significantly affected by COVID-19. |