· Pediatric cerebrospinal fluid (CSF) components have been extensively evaluated as biomarkers of various neurologic diseases. · Several promising candidate CSF biomarkers, including Tau, glial fibrillary acidic protein, neuron-specific enolase, S100β, and interleukins, have been studied in pediatric patients with seizure disorders, central nervous system infections, inflammation, tumors, hypoxic-ischemic encephalopathy, traumatic brain injuries, intraventricular hemorrhage, and congenital hydrocephalus. · Circulating microRNAs in the CSF are a promising class of biomarkers for various neurological diseases. |
Question: Simulation-based ultrasound training is becoming more popular. Is there a role for pediatricians in such training programs? Finding: Our program received promising feedback from its participants. Self-rated confidence in image interpretation and ultrasound-guided catheter insertion improved after the simulation. Participants reported a higher preference for performing ultrasound scans before radiologist assessment. Meaning: Ultrasound training can be considered as part of the pediatric training curriculum in the future. |
Question: It is well known that autonomic dysfunction contributes to vasovagal syncope (VVS). Does the degree of autonomic dysfunction contribute to clinical manifestations, diagnostic methods, treatment, and prognosis? Finding: The clinical manifestations, diagnostic methods, treatment, and prognosis differ between patients with mild and moderate degrees of autonomic dysfunction. Meaning: VVS is caused by autonomic dysfunction, but autonomic dysfunction severity need not be classified. |
Question: Are parent and child obesity correlated worldwide? Finding: Overweight and obese status of parents and children were significantly associated worldwide. The association between parent and child obesity was stronger in Asia than in Europe and the Middle East, and in high-income than in middle- and low-income countries. Meaning: Childhood obesity is highly influenced by parental weight status, indicating that parents could play an important role in its prevention. |
Growing point-of-care ultrasound (POCUS) use in pediatric patients has led to the need for POCUS education for pediatric residents. Recent experimental studies have suggested that POCUS education improves self-rated POCUS confidence and comfort in pediatric resident training. Considering the effective and sustainable POCUS education curriculum in pediatric resident training, simulation-based education would be a solution. |
•The prevalence of childhood obesity is increasing worldwide, including in the Republic of Korea, creating a major public healthissue. •Accumulated evidence indicates a strong relationship between parentalandchildobesity. •A family-based approach is indicated to prevent and manage childhoodandadultobesity. |
• With the emerging epidemic of pediatric obesity, many endocrine comorbidities classically seen in adulthood are surfacing much earlier in life. • Appropriate obesity counseling and education should be provided from infancy to adolescence. • Managing pediatric obesity may require school and society involvement. |
· Clinical manifestations of upper gastrointestinal (UGI) tract involvement in Crohn's disease (CD) are common but often clinically underestimated. · Diagnosing CD by confirming inflammation of the UGI tract histologically is challenging because macroscopic and microscopic findings overlap with those of other diseases. · Ongoing efforts are needed to enable a standardized assessment of UGI CD in the future. |
∙ Prevalence rate of developmental disabilities has been reported from 8% to 15% and its rate is increasing worldwide. ∙ The critical period of intervention for developmental delay is before the child reaches 3 years of age. ∙ All primary care pediatricians should conduct developmental surveillance and screening tests to infants and children at scheduled visits. Through this, they are liable for providing early identification and timely intervention. |
∙ The growth of preterm infants is a main focus of neonatology. ∙ Preterm infants in Korea, especially those with a very low birth weight, achieve retarded growth. ∙ Careful growth monitoring and early intervention will contribute to better development outcomes and quality of life for preterm infants and improve public health. |
Question: What are the distinctive features of rural children with atopic dermatitis? Finding: Birch and dog dander were the second most sensitized aeroallergens (32.6%), followed by house dust mites. Doctors and guardians reported food allergy comorbidities differently (19.9% and 43.5%, respectively). Dietary restrictions without medical evaluation were observed in 39.7% of patients. Meaning: Effects of pollen distribution and indirect animal exposure should be evaluated. Evidence-based dietary restrictions must be implemented. |
Question: What is the natural course of viral load in children with coronavirus disease 2019 (COVID-19)? Finding: A significant number of patients still had a relatively high viral load once clinically asymptomatic. Nearly half of the patients experienced viral rebound, which contributed to prolonged viral detection in their respiratory specimens. Meaning: Further studies are needed to determine the clinical significance of viral rebound in asymptomatic or mild pediatric cases of COVID-19. |
Question: Do probiotics reduce colic symptoms? Finding: Probiotics reduced colic symptoms in colicky infants probably due to the anti-inflammatory properties. Meaning: Probiotics may be an effective and less noxious way to manage infantile colic. |
Question: We assessed the spatial modeling of mortality from acute lower respiratory infections in children under 5 years old during 2000–2017 using a global data. Finding: The total number of child deaths during the study period decreased, while the number of hot spots increased among countries. Meaning: Hot spots were concentrated in Asia in 2000 but shifted toward African countries by 2017. A cold spot formed in Europe over the study period. |
Acute lower respiratory infection (ALRI) is the leading cause of death among children under 5 years of age worldwide, especially in low- and middle-income countries. A spatial analysis explains the trends and severity based on the conditions of each country. Countries in Asia and Africa experience many cases of mortality caused by ALRI. |
Neonatal encephalopathy is the most important reason for morbidity and mortality. The early detection of neonate with high risk for hypoxic ischemic encephalopathy (HIE) and treatment are important for prevent long term complication. Hypothermia is currently standard treatment option for HIE. Several clinical studies have been performed due to improve the long term outcome. New therapeutic options including xenon, allopurinol, erythropoietin, topiramate will help to reduce neuropsychiatric disability. |
∙ Pediatric obesity can involve endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty. ∙ Prediabetes and type 2 diabetes in youth aged 10–19 years had a prevalence of 25.9% and 0.6% in 2013–2014, respectively. ∙ Dyslipidemia in Korean adolescents aged 10–18 years had a prevalence of 7.64% (total cholesterol ≥200 mg/dL), 6.09% (low-density lipoprotein cholesterol ≥130 mg/dL), 8.69% (triglyceride ≥150 mg/dL), and 12.52% (high-density lipoprotein cholesterol ≤40 mg/dL) in 2007–2018. ∙ Metabolic syndrome in Korean youth has a prevalence of 1.9%–14.7% in males and 1.7%–12.6% in females with wide variation in definitions. ∙ Appropriate comorbidity screening and management and/or specialist referral are necessary for obese children and adolescents. |
∙ Cognitive impairments occur in children with hypoxic-ischemic encephalopathy (HIE) even without neuromotor deficits. ∙ Therapeutic hypothermia has improved neurodevelopmental outcomes of children with HIE; however, 40% of children remain at risk of death/disability or cognitive impairments necessitating the development of adjunctive neuroprotective therapies. ∙ Long-term follow-up until adolescence is required to identify cognitive dysfunction. ∙ A pattern of watershed injury on brain imaging is associated with poor cognitive outcomes. |
∙ Diphtheria and tetanus toxoids and acellular pertussis-inactivated poliovirus-Haemophilus influenzae type b-hepatitis B (DTaP-IPV-Hib-HepB) was licensed in Korea in April 2020. ∙ DTaP-IPV-Hib-HepB is indicated as a 3-dose primary series for infants aged 2, 4, and 6 months who received the standalone HepB vaccine at birth. ∙ Infants born to HepB surface antigen-positive mothers are currently recommended to be immunized with HepB immunoglobulin at birth and then monovalent HepB vaccine at 0, 1, and 6 months. |
Question: Are multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) in infants, 2 sides of the same coin? Finding: Here we report on a 4-month-old girl with MIS-C and signs of KD with shock. Most (83%) infants with MIS-C had features of KD, especially KD shock syndrome. Meaning: MIS-C is similar to KD, and likely is a consequence of dysregulated immune responses secondary to sudden acute respiratory syndrome coronavirus 2 infection. |
Question: Can multisystem inflammatory syndrome in childhood (MIS-C) occur in the neonate associated with coronavirus disease 2019 (COVID-19)? Finding: A 9-day-old neonate infected with COVID-19 had fever, respiratory distress, and gastrointestinal symptoms suggestive of MIS-C. This neonate recovered after treatment with intravenous immunoglobulin (IVIG). Meaning: IVIG successfully treated a rare case of a 9-day-old neonate with COVID-19 and severe symptoms suggestive of MIS-C. |
Question: Is the incidence of childhood pneumonia influenced by breastfeeding and basic immunization status? Finding: Exclusive breastfeeding and complete basic immunization status have an effect in limiting the incidence of childhood pneumonia. Meaning: While exclusive breastfeeding and complete basic immunization the Expanded Program on Immunization status are important factors for reducing the incidence of childhood pneumonia, indoor air pollution was also a significant risk factor. |
Question: Does a subtle deterioration in cardiac function affect the severity of syncope in patients without underlying disease? Finding: For syncope patients with reasonable cardiac function but without underlying disease, tissue Doppler imaging (TDI) measurements helped reveal subtle differences in cardiac function with syncope and predicted the severity of syncope or a potential recurrent event. Meaning: TDI measurements might be a useful indicator for predicting the severity of syncope. |
Is the global prevalence of toxocariasis high among children? The prevalence of toxocariasis is high in pediatric patients. Asian children are more susceptible to the disease than other children. Its virulence varies among different socioeconomic classes in various countries. Hand washing after soil contact, routine pet deworming, and appropriate disposal of pet feces in households with Asian pediatrics are needed to prevent toxocariasis. |
While the majority of infantile hemangiomas (IHs) do not require therapy and regress spontaneously, about 10%–15% develop complications such as ulceration, obstruction, or disfigurement. Early intervention is recommended for infants with potentially problematic IHs. Oral propranolol 2–3 mg/kg/day is currently the treatment of choice. |
· Infantile hemangiomas (IHs) are the most common benign vascular tumors, occurring in 5%–10% of infants. · IHs are characteristically not present at birth but are usually diagnosed at 1–4 weeks of age, rapidly proliferate until 5 months of age, and then spontaneously involute. · High-risk IHs (10%) require early treatment from 1 month of age. · Oral propranolol, a nonselective beta-blocker, is the first-line treatment for IHs. |
· Among North Korean refugee (NKR) children under 5 years, 61% and 9.3% were underweight in 1998 and 2017, respectively. · The immunization rate of NKR children exceeded 90% since 2006. · For NKR children, protein-energy malnutrition was the #1 cause of death in 2009 versus #17 in 2019. · In 2020, stunting affected 5.4% and 0.9% and obesity affected 10.7% and 2.7% of NKR versus South Korean children, respectively. |
· The nasal microbiota varies with age and is shaped by various factors in healthy individuals. · The pathological condition of the respiratory tract appears to be associated with reduced nasal microbiota biodiversity, while dysbiosis is involved in the pathophysiology of many respiratory diseases, including otitis, sinusitis, allergic diseases, and lower respiratory infections. |
• The relationship between small for gestational age (SGA) and autism spectrum disorders (ASDs) and remains conflicting. • We showed based on odds ratio reports in epidemiological studies that SGA can increase the risk of ASD and SGA is a risk factor for ASD. • The association between SGA and the risk of ASD has further momentum to the current public health emphasis on appropriate prepregnancy weight and weight gain during pregnancy |
Question: What are the clinical spectrum, course, and short-term outcomes of multisystem inflammatory syndrome in children (MIS-C)? Finding: MIS-C can have variable clinical manifestations. Fever is most common, followed by gastrointestinal and cardiovascular symptoms. Early identification and appropriate management lead to favorable outcomes. Meaning: MIS-C can present in a myriad of ways and severities. High suspicion is necessary to ensure its early identification and appropriate management and favorable patient outcomes. |