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Review Article
Developmental and Behavioral Medicine
Spontaneous movements as prognostic tool of neurodevelopmental outcomes in preterm infants: a narrative review
Hyun Iee Shin, Myung Woo Park, Woo Hyung Lee
Clin Exp Pediatr. 2023;66(11):458-464.   Published online May 16, 2023
· Spontaneous movements can be useful to evaluate neuronal integrity in preterm infants.
· In General Movements Assessment, continuous cramped synchronized movements and absent fidgety movements can indicate high-risk infants for cerebral palsy.
· Recent advances in machine learning techniques have led to the automated prediction of cerebral palsy based on infantile spontaneous movements.
Original Article
Cardiology
Echocardiographic reference z scores of right ventricular dimension and systolic function of children aged 5–12 years
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.
Review Article
Infection
COVID-19 in immunocompromised children and adolescents
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
Hematology
Changes and correlations of T-cell coinhibitory molecule programmed death-1 and interferon-γ in pediatric immune thrombocytopenia
Fady Mohamed El-Gendy, Amira M.F. Shehata, Esam Awad Abd El-Kawy, Mahmoud Ahmed El-Hawy
Clin Exp Pediatr. 2023;66(3):127-133.   Published online February 24, 2023
Question: What are the PD-1+ CD4+ T cells percentages and serum interferon gamma (IFN-γ) levels of pediatric patients with immune thrombocytopenia (ITP)?
Finding: Compared with healthy controls, the PD-1+ CD4+ T cells percentages and IFN-γ levels were significantly higher in ITP patients before and 1 month after therapy.
Meaning: Our findings suggest that PD-1+ CD4+ T cells and IFN-γ are involved in the pathophysiological process of ITP.
Review Article
Neurology
Pediatric syncope: pearls and pitfalls in history taking
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.
Infection
Pathogenetic and etiologic considerations of febrile seizures
Ji Yoon Han, Seung Beom Han
Clin Exp Pediatr. 2023;66(2):46-53.   Published online January 13, 2023
· Inflammatory responses accompanying fever increase neuronal excitability in the central nervous system, which in turn provokes seizures.
· Fever in children with febrile seizures is usually caused by common respiratory viruses, the distributions of which match those of seasonal community-acquired respiratory tract infections.
· Several genetic variations in ion channels seem associated with neuronal hyperexcitability in children with febrile seizures.
Other
Hearing loss in neonates and infants
Goun Choe, Su-Kyoung Park, Bong Jik Kim
Clin Exp Pediatr. 2023;66(9):369-376.   Published online January 9, 2023
· Congenital hearing loss is common, with an approximate incidence of 1.5 per 1,000 newborns and affecting 1.2%–11% of preterm and 1.6%–13.7% of neonatal intensive care unit neonates.
· Etiologies vary, and up to 80% of cases are genetic.
· Newborn hearing screenings follow the 1-3-6 rule, and babies at high risk of hearing loss should be referred to otolaryngology for early detection and timely intervention.
Allergy
Recent topics on gastrointestinal allergic disorders
Yoshiyuki Yamada
Clin Exp Pediatr. 2023;66(6):240-249.   Published online January 9, 2023
Gastrointestinal (GI) allergies are divided into immunoglobulin E (IgE)-mediated, non-IgE-mediated, and mixed types. In addition to non-IgE-mediated, overlapping eosinophilic GI disorders (EGIDs) have increased in Japan. EGIDs, a mixed-type allergy category, include eosinophilic esophagitis (EoE) and non-EoE EGIDs. The number of EoE cases has increased in Western countries, followed by Asian countries. Recent GI allergies may also be associated with type 2 inflammation.
Gastroenterology
Update on eosinophilic gastrointestinal disease beyond eosinophilic esophagitis in children
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.
Neonatology (Perinatology)
Neurodevelopmental outcomes of preterm infants
In Gyu Song
Clin Exp Pediatr. 2023;66(7):281-287.   Published online December 30, 2022
· Among survivors, 60.9% of infants born at 22 weeks’ gestation had moderate to severe impairments, whereas 50.3% born at 23 weeks’ and 42.2% at 24 weeks’ gestation had moderate to severe impairments.
· Moderate and late preterm infants reportedly have less severe disease than very preterm infants, but they still experience adverse neurodevelopmental outcomes.
· The careful follow-up and early detection of developmental problems in these patients are required.
Neurology
Electroencephalography source localization
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
Infection
Seroprevalence of maternal peripartum human T-cell lymphotropic virus type-1 infection: a systematic review and meta-analysis of the Nigerian literature
Abdulrasheed Usman, Muhammad Hamis Musa, Bukhari Isah Shuaib, Olayemi Balogun, Mukhtar Adeiza
Clin Exp Pediatr. 2023;66(7):307-316.   Published online December 22, 2022
The peripartum period is an important transmission time for human T-cell lymphotropic virus-1 (HTLV-1) infection, mainly via breastfeeding and partly through the placental tissues of carrier mothers. Although most HTLV-1–infected individuals are asymptomatic, fetal and childhood infections often result in several diseases with disappointing treatment outcomes. An estimated HTLV-1 burden in Nigeria among perinatal women must be determined to enable rational planning of a comprehensive health care intervention.
Review Article
General Pediatrics
Korean Developmental Screening Test for Infants and Children (K-DST): development, applications, and implications for future early childhood development interventions
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.
Gastroenterology
Liver fibrosis in children: a comprehensive review of mechanisms, diagnosis, and therapy
Elif Ozdogan, Cigdem Arikan
Clin Exp Pediatr. 2023;66(3):110-124.   Published online December 19, 2022
· Chronic liver diseases in children are heterogenous but converge in the common pathway of fibrosis.
· Much of the literature on mechanisms of fibrogenesis focus on adults but pediatric physiology has documented differences.
· Understanding of these distinctions are necessary to define, treat, and prevent fibrosis.
· Current management of liver fibrosis relies heavily on liver biopsy. Multiple tools have shown high diagnostic performance in pediatric and adult populations. Large, multicenter studies are needed for validation.
Original Article
Neonatology (Perinatology)
A thickened formula reduces feeding-associated oxygen desaturation and bradycardia in preterm infants
Gayoung Lee, Juyoung Lee, Ga Won Jeon, Yong Hoon Jun
Clin Exp Pediatr. 2023;66(1):32-37.   Published online December 15, 2022
Question: Is a commercial thickened formula able to alleviate oral feeding-associated desaturation and bradycardia in preterm infants?
Finding: Thickened formula feeding significantly reduced oral feeding-associated desaturation and bradycardia in preterm infants.
Meaning: Thickened formula feeding stabilizes oxygen saturation and heart rate during oral feeding among preterm infants with feeding difficulties.
Efficacy of body position on gastric residual in preterm infant: a systematic review and meta-analysis
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.
Gastroenterology
Association between maternal weight gain during pregnancy and child’s body mass index at preschool age
Jeewon Shin, Yoowon Kwon, Ju Hee Kim, Su Jin Jeong
Clin Exp Pediatr. 2023;66(2):76-81.   Published online November 30, 2022
Question: What are the risk factors of newborn birth weight? Does gestational weight gain and prepregnancy body mass index affect childhood weight?
Finding: Excess maternal weight gain increases the risk of overweight/obesity, newborn birth weight, and child body mass index at 4–6 years.
Meaning: Maternal weight control before and during pregnancy should be well controlled.
Neurology
Long-term neurological cognitive, behavioral, functional, and quality of life outcomes after fetal myelomeningocele closure: a systematic review
Andre Marolop Pangihutan Siahaan, Martin Susanto, Sarma Nursani Lumbanraja, Dwi Herawati Ritonga
Clin Exp Pediatr. 2023;66(1):38-45.   Published online November 30, 2022
· Fetal myelomeningocele closure significantly improved long-term neurological cognitive, behavioral, functional, and quality of life outcomes, most likely by reducing hydrocephalus rates.
· However, fetal myelomeningocele closure is associated with a significant risk of pregnancy complications, especially premature rupture of membranes and preterm delivery.
Review Article
Neurology
Gut microbiota affects brain development and behavior
Gun-Ha Kim, Jung-Ok Shim
Clin Exp Pediatr. 2023;66(7):274-280.   Published online November 8, 2022
· The gut microbiota can alter a host’s brain development and behavior.
· Gut bacteria communicate with the brain via the microbiota-gut-brain axis.
· Fecal microbial transplantation is a promising treatment strategy for autism spectrum disorder.
Infection
Global varicella vaccination programs
Young Hwa Lee, Young June Choe, Jia Lee, Eunseong Kim, Jae Young Lee, Kwan Hong, Yoonsun Yoon, Yun-Kyung Kim
Clin Exp Pediatr. 2022;65(12):555-562.   Published online November 2, 2022
It is important to evaluate its effectiveness at the national level and to determine the varicella vaccine schedule based on the evidence generated through the studies.
Nutrition
Protein substitutions as new-generation pharmanutrition approach to managing phenylketonuria
Fatma Nur Keskin, Teslime Özge Şahin, Raffaele Capasso, Duygu Ağagündüz
Clin Exp Pediatr. 2023;66(8):320-331.   Published online November 1, 2022
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.
Original Article
Pulmonology
Predictors of high-flow nasal cannula failure in pediatric patients with acute respiratory distress
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.
Gastroenterology
Ability of polymicrobial probiotic and mono-strain probiotic to reduce functional abdominal pain in children: a randomized clinical trial
Seyed Sajad Jafari, Seyed Mojtaba Hashemi, Bahman Sadeghi, Amir Almasi-Hashiani
Clin Exp Pediatr. 2022;65(12):589-594.   Published online October 31, 2022
· This study compared the ability of 2 probiotics to reduce and improve functional abdominal pain (FAP) in children.
· In the polymicrobial probiotic (PMP) group, 10.34% of children reported no pain; in the mono-strain probiotic (MSP) group, all patients reported low-degree pain. The mean pain score decreased significantly over time in both groups.
· The use of both PMP and MSP is recommended to reduce pain in patients with FAP.
Review Article
Allergy
New approaches to immunotherapy in house dust mite allergy
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,...
Gastroenterology
High-resolution esophageal manometry in children
Yogesh Waikar
Clin Exp Pediatr. 2023;66(4):155-160.   Published online October 17, 2022
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.
Nutrition
Total energy expenditure measured by doubly labeled water method in children and adolescents: a systematic review
Nahyun Kim, Jonghoon Park
Clin Exp Pediatr. 2023;66(2):54-65.   Published online October 17, 2022
This systematic review summarizes convincing evidence that total energy expenditure (TEE) measured using the doubly labeled water technique increased with age from 1 to 18 years, while fat-free mass (FFM) increased with growth. TEE and in normal-weight participants, while physical activity level did not differ from that of normal-weight participants.
Pulmonology
Epidemiology and surveillance implications of community-acquired pneumonia in children
Eui Jeong Roh, Jung Yeon Shim, Eun Hee Chung
Clin Exp Pediatr. 2022;65(12):563-573.   Published online October 17, 2022
The identification of the causative pathogens of community-acquired pneumonia and appropriate treatment and prevention can reduce mortality and the socioeconomic burden by reducing the medical expenses. The world has been in the coronavirus disease 2019 pandemic since 2020, and there is always a risk of continuous emergence and epidemic of new respiratory infectious diseases. Therefore, it is important to sustain a monitoring system for respiratory infectious diseases including pneumonia.
Original Article
Gastroenterology
Probiotics added to maternal nutrition affect ınfantile colic symptoms and fecal microbiota profile: a single-blind randomized controlled study
Aysu Yıldız Karaahmet, Gülümser Dolgun, Metehan Özen
Clin Exp Pediatr. 2022;65(11):547-554.   Published online September 23, 2022
Question: Do probiotics added to maternal nutrition affect infantile colic symptoms and intestinal microbiota?
Finding: Infants whose mothers ingested probiotics demonstrated decreased crying frequency and intensity and significantly increased bacterial diversity in the stools. The bacterial variety was substantially affected by the added probiotic product.
Meaning: The addition of probiotics to maternal nutrition in early infancy could play an important role in preventing infantile colic.
Review Article
Critical Care Medicine
Ferritin in pediatric critical illness: a scoping review
Ivy Cerelia Valerie, Anak Agung Sagung Mirah Prabandari, Dyah Kanya Wati
Clin Exp Pediatr. 2023;66(3):98-109.   Published online September 16, 2022
The number of studies on ferritin predictive ability in pediatric critical illness has grown exponentially over the past 2 decades. However, among the 66 of 1,580 studies analyzed here, summary statistics for overall and condition-specific studies were only reported in 45.4% and 71.2%, respectively. In contrast, ferritin as a categorical variable with a preset threshold was a significant predictor in 84.6% of studies.
Original Article
Neurobehavior
Association between previous abortion history and risk of autism spectrum disorders among offspring: a meta-analysis
Ensiyeh Jenabi, Erfan Ayubi, Saeid Bashirian, Mahdieh Seyedi, Mohammad Rezaei
Clin Exp Pediatr. 2023;66(2):70-75.   Published online August 17, 2022
Question: This study aimed to determine whether there is an association between previous abortion history and the risk of autism spectrum disorders (ASDs) among children.
Finding: We found that the risk of ASD associated with previous abortion history had an odds ratio of 1.64 (95% confidence interval, 1.28–2.0; I2=61.7%).
Meaning: These findings suggest a positive and significant association between history of previous abortion and risk of ASD in children.