Clinical and Experimental Pediatrics

Original Article

Genetics and Metabolism

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

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

Letter to the Editor

Hematology

Neutropenia following metamizole use in pediatric patients: a multicenter retrospective study

Meraj Alam Siddiqui, Arzu Akyay, Fatma Burcu Belen Apak, Özgür Carti, Canan Albayrak, Melek İşik, Zühre Kaya, Sevgi Yetgin, Lale Olcay

Clin Exp Pediatr. 2024;67(8):415-417. Published online July 23, 2024

DOI: https://doi.org/10.3345/cep.2024.00262

Original Article

Infection

Construction and validation of predictive models for intravenous immunoglobulin–resistant Kawasaki disease using an interpretable machine learning approach

Linfan Deng, Jian Zhao, Ting Wang, Bin Liu, Jun Jiang, Peng Jia, Dong Liu, Gang Li

Clin Exp Pediatr. 2024;67(8):405-414. Published online July 23, 2024

Web of Science 3 Crossref 1

Question: Is there a reliable model to predict intravenous immunoglobulin (IVIG)-resistant Kawasaki disease (KD)?
Finding: We constructed 5 machine learning models to predict IVIG-resistant KD. Extreme gradient boosting (XGBoost) model was superior to logistic, support vector machine, light gradient boosting machine and multiple layers perception models. The SHAP (SHapley Additive exPlanations) value interpreted the contribution of each feature in XGBoost model.
Meaning: XGBoost model showed the excellent performance to predict IVIG-resistant KD with explainable and visualizable machine learning algorithm.

DOI: https://doi.org/10.3345/cep.2024.00549

Developmental and Behavioral Medicine

Neonatal risk factors associated with autism spectrum disorders: an umbrella review

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

Web of Science 2 Crossref 2

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.

DOI: https://doi.org/10.3345/cep.2024.00136

Review Article

Neonatology (Perinatology)

Demographic transition in South Korea: implications of falling birth rates

Chae Young Kim, Sung-Hoon Chung

Clin Exp Pediatr. 2024;67(10):498-509. Published online June 27, 2024

Web of Science 4 Crossref 4

· Since 1960, South Korea's TFR decreased from 6.33 to 0.78 in 2022, below the 2.1 replacement level since 1983, with women's average age at first marriage rising to 31.3 in 2022.
· Policies needed: financial incentives, longer parental leave, better childcare.
· The U.S. (15.3% immigrants) and Germany (18.8%) use immigration to maintain demographic stability, a strategy South Korea is considering.

DOI: https://doi.org/10.3345/cep.2023.01599

Endocrinology

Two- versus one-bag fluid delivery in pediatric and adolescent diabetic ketoacidosis: a systematic review and meta-analysis

Maya L. Nasser, Joseph Nasr, Reem B. Zalloum, Nathanael Q.E. Yap, Natalie E. Bourdakos, Shahid Miangul, Tara A. Betts, Hayato Nakanishi, Christian A. Than, Serge Jabbour

Clin Exp Pediatr. 2024;67(10):486-497. Published online June 27, 2024

Crossref 2

· 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.

DOI: https://doi.org/10.3345/cep.2023.01536

Original Article

Nutrition

Parental support and exclusive breastfeeding at 3 months in West Java, Indonesia: a mixed-methods approach

Ratu Ayu Dewi Sartika, Fadila Wirawan, Wawan Gunawan, Primasti Nuryandari Putri, Nurul Husna Mohd Shukri

Clin Exp Pediatr. 2024;67(7):358-367. Published online June 21, 2024

Web of Science 1

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.

DOI: https://doi.org/10.3345/cep.2023.01375

Letter to the Editor

Developmental and Behavioral Medicine

Efficacy of social skills group intervention among children with mild autism spectrum disorder

Lee Ling Low, Ker Yang Chua, Bih Hwa Ching

Clin Exp Pediatr. 2024;67(7):368-370. Published online May 31, 2024

DOI: https://doi.org/10.3345/cep.2024.00122

Review Article

Developmental and Behavioral Medicine

Comprehensive evaluation of the child with global developmental delays or intellectual disability

Abdullah Nasser Aldosari, T. Saeed Aldosari

Clin Exp Pediatr. 2024;67(9):435-446. Published online May 29, 2024

Web of Science 3 Crossref 3

· 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.

DOI: https://doi.org/10.3345/cep.2023.01697

Letter to the Editor

Neonatology (Perinatology)

Pentraxin 3 as a marker of early-onset neonatal sepsis

Safaa ELMeneza, Iman El-Bagoury, Hind Rayes, Amira Hassan

Clin Exp Pediatr. 2024;67(6):312-314. Published online May 23, 2024

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2024.00409

Original Article

Developmental and Behavioral Medicine

Effectiveness of online responsive teaching in young children with developmental disabilities: a pilot study

Jung Sook Yeom, Jeongmee Kim

Clin Exp Pediatr. 2024;67(6):303-311. Published online May 21, 2024

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2023.01662

Endocrinology

Kisspeptin and DLK1 levels for monitoring treatment of girls with central precocious puberty

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 5 Crossref 5

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

Editorial

Neurobehavior

Importance of pediatrician’s role in preventing positional plagiocephaly

Hee-Jeong Kang

Clin Exp Pediatr. 2024;67(6):294-295. Published online May 21, 2024

· 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.

DOI: https://doi.org/10.3345/cep.2023.01025

Review Article

Hematology

Iron deficiency in children with a focus on inflammatory conditions

Na Hee Lee

Clin Exp Pediatr. 2024;67(6):283-293. Published online May 21, 2024

Web of Science 4 Crossref 6

· 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.

DOI: https://doi.org/10.3345/cep.2023.00521

Other

Use of virtual reality in children in a broad range of medical settings: a systematic narrative review of recent meta-analyses

Emily Antonovics, Grammatina Boitsios, Thomas Saliba

Clin Exp Pediatr. 2024;67(6):274-282. Published online May 21, 2024

Web of Science 6 Crossref 8

· 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.

DOI: https://doi.org/10.3345/cep.2023.00388

Allergy

Action-plan and as-needed therapy in allergic rhinitis

Hyeon-Jong Yang

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

Web of Science 3 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

Editorial

Infection

Preventing bloodstream infections in children after liver transplantation

Young June Choe

Clin Exp Pediatr. 2024;67(11):599-600. Published online April 18, 2024

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.

DOI: https://doi.org/10.3345/cep.2024.00045

Immunology

Utility of eosinophil granule proteins in management of pediatric chronic cough

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

Original Article

Pulmonology

Oligohydramnios affects pulmonary functional/structural abnormalities in school-aged children with bronchopulmonary dysplasia

Jeong Eun Shin, Soon Min Lee, Mi-Jung Lee, Jungho Han, Joohee Lim, Haerin Jang, Ho Seon Eun, Min Soo Park, Soo Yeon Kim, Myung Hyun Sohn, Ji Ye Jung, Kyung Won Kim

Clin Exp Pediatr. 2024;67(5):257-266. Published online April 16, 2024

Web of Science 4 Crossref 5

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.

DOI: https://doi.org/10.3345/cep.2023.01053

Review Article

Infection

Incidence, causative organisms, and risk factors of bloodstream infections in pediatric liver transplant patients: a systematic review

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

Web of Science 1 Crossref 1

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.

DOI: https://doi.org/10.3345/cep.2023.01466

Original Article

Neonatology (Perinatology)

Effect of vitamin E supplementation on bilirubin levels in infants with hyperbilirubinemia: a double-blind randomized clinical trial

Mojtaba Cheraghi, Maziar Nikouei, Majid Mansouri, Siros Hemmatpour, Yousef Moradi

Clin Exp Pediatr. 2024;67(5):249-256. Published online March 26, 2024

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.

DOI: https://doi.org/10.3345/cep.2023.01312

Editorial

Neurology

Impact of COVID-19 pandemic on clinical features of benign convulsions with mild gastroenteritis

Jon Soo Kim

Clin Exp Pediatr. 2024;67(9):456-458. Published online March 25, 2024

· 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.

DOI: https://doi.org/10.3345/cep.2024.00108

Letter to the Editor

Neonatology (Perinatology)

Assessment of iron status and red cell parameters in healthy term small for gestational age neonates at birth

Arif Hossain, Shorna Rahman, Shahana Akter, Ismat Jahan, Sanjoy Kumer Dey, Abdul Mannan, Mohammod Shahidullah

Clin Exp Pediatr. 2024;67(4):221-223. Published online March 19, 2024

DOI: https://doi.org/10.3345/cep.2023.01445

Original Article

Neurology

Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study

Hyejin Na, Sanghoon Lee, Seo Hee Kim, Young Ok Kim

Clin Exp Pediatr. 2024;67(4):213-220. Published online March 19, 2024

Web of Science 2 Crossref 2

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.

DOI: https://doi.org/10.3345/cep.2023.01137

Nutrition

Effect of probiotics plus zinc supplementation on clinical outcomes of infants and children with acute infectious diarrhea: a randomized controlled trial

Deldar Morad Abdulah, Saad Jbraeil Sulaiman, Zaid Waad Ahmed

Clin Exp Pediatr. 2024;67(4):203-212. Published online February 19, 2024

Web of Science 4 Crossref 6

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.

DOI: https://doi.org/10.3345/cep.2023.01340

Letter to the Editor

Pulmonology

Metabolic syndrome and pulmonary dysfunction in asthmatic children during the COVID-19 pandemic

Jue Seong Lee, Sang Hyun Park, Yoon Lee, Seunghyun Kim, Wonsuck Yoon, Young Yoo

Clin Exp Pediatr. 2024;67(3):168-170. Published online February 19, 2024

Web of Science 1 Crossref 1

DOI: https://doi.org/10.3345/cep.2023.01480

Original Article

Neonatology (Perinatology)

Oral administration of bone marrow-derived mesenchymal stem cells attenuates intestinal injury in necrotizing enterocolitis

Yeong Seok Lee, Yong Hoon Jun, Juyoung Lee

Clin Exp Pediatr. 2024;67(3):152-160. Published online February 19, 2024

Web of Science 5 Crossref 5

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.

DOI: https://doi.org/10.3345/cep.2023.01151

Editorial

Critical Care Medicine

Is it possible to provide palliative care to pediatric patients with neurological diseases?

Young-Hoon Kim

Clin Exp Pediatr. 2024;67(8):403-404. Published online February 15, 2024

· 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.

DOI: https://doi.org/10.3345/cep.2023.01032

Letter to the Editor

General Pediatrics

Vitamin B₁₂ deficiency in anemic children before versus after age 2 years: a form of hidden hunger in India

Sahil Goel, Ruchika Bhatnagar, Anita Kumari, Brig Prem Lochan Prasad, Lahar Sahai

Clin Exp Pediatr. 2024;67(2):116-118. Published online January 24, 2024

DOI: https://doi.org/10.3345/cep.2023.01347

Editorial

Endocrinology

Nonalcoholic fatty liver disease in children and adolescents

Hae Sang Lee

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

Web of Science 3 Crossref 3

· 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

Cited By 31	Neurodevelopmental outcomes of preterm infants
Cited By 29	Long COVID in children and adolescents: prevalence, clinical manifestations, and management strategies
Cited By 27	Gut microbiota affects brain development and behavior
Cited By 24	Association of gut microbiota with obesity in children and adolescents
Cited By 24	Prevalence of anxiety, depression, and stress among parents of neonates admitted to neonatal intensive care unit: a systematic review and meta-analysis

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