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Correspondence
Cardiology
The authors reply: Age-, sex-, and height-based blood pressure reference charts, Yazd children 6–18 years, Iran
Seyedeh Mahdieh Namayandeh, Nastran Ahmadi, Seyed Mahmood Sadr
Clin Exp Pediatr. 2023;66(9):414-414.   Published online June 14, 2023
General Pediatrics
Letter to the editor: Age-, sex-, and height-based blood pressure reference charts, Yazd children 6-18 years, Iran
Amar Taksande
Clin Exp Pediatr. 2023;66(9):412-413.   Published online October 27, 2021
Original Article
Critical Care Medicine
Timing of parenteral nutrition initiation in critically ill children: a randomized clinical trial
Nagwan Y. Saleh, Hesham M. Aboelghar, Nehad B. Abdelaty, Mohamed I. Garib, Asmaa A. Mahmoud
Clin Exp Pediatr. 2023;66(9):403-411.   Published online June 14, 2023
Question: What is the ideal initiation timing of parenteral nutrition for critically ill children?
Finding: This randomized clinical trial of 140 children examined the effects of an early or late start of parenteral nutrition on mechanical ventilation need (primary outcome) and length of stay and mortality (secondary outcomes).
Meaning: Children who received early versus late parenteral nutrition had lower mechanical ventilation need and duration.
Gastroenterology
Relationship between nonalcoholic fatty liver disease and hyperandrogenemia in adolescents with polycystic ovary syndrome
Ozlem Kara, Hanife Aysegul Arsoy, Murat Keskin
Clin Exp Pediatr. 2023;66(9):395-402.   Published online June 14, 2023
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.
Review Article
Neonatology (Perinatology)
Treatment of congenital cytomegalovirus infection
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(9):384-394.   Published online December 28, 2022
· Congenital cytomegalovirus (CMV) infection is among the most common causes of nongenetic sensorineural hearing loss.
· Congenital CMV is initially treated with intravenous ganciclovir for 2–6 weeks and switched to oral valganciclovir, or with oral valganciclovir for the entire 6-month period.
· Infants with congenital CMV require periodic monitoring of absolute neutrophil count, platelet count, and blood urea nitrogen, creatinine, liver function tests, audiological, ophthalmological, and developmental tests during antiviral medication.
Gastroenterology
Prevalence, risk factors, and treatment of small intestinal bacterial overgrowth in children
Yu Kyung Cho, Jin Lee, Chang Nyol Paik
Clin Exp Pediatr. 2023;66(9):377-383.   Published online August 21, 2023
· Pediatric small intestinal bacterial overgrowth (SIBO) manifestations range from nonspecific abdominal symptoms to malabsorption or malnutrition.
· SIBO is prevalent in children and adolescents with functional abdominal pain disorders.
· Predisposing factors include disturbed intestinal motility, altered anatomy, and/or abnormal body defense systems against intestinal bacteria.
· Breath tests are safe and noninvasive.
· Treatment principles include managing predisposing conditions, nutritional support, symptom control, and antibiotics.
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.
Letter to the Editor
Infection
SARS-CoV-2 fecal shedding pattern in pediatric patients with acute COVID-19 or COVID-19-associated multisystem inflammatory syndrome
Setareh Mamishi, Fatemeh Jalali, Sepideh Benvari, Babak Pourakbari, Mohammad Reza Abdolsalehi, Reihaneh Hosseinpour Sadeghi, Mohammad Shahbabaie, Amene Navaeian, Shima Mahmoudi
Clin Exp Pediatr. 2023;66(8):366-368.   Published online June 14, 2023
Original Article
Allergy
Association between dyslipidemia and asthma in children: a systematic review and multicenter cohort study using a common data model
Ji Eun Lim, Hye Min Kim, Ju Hee Kim, Hey Sung Baek, Man Yong Han
Clin Exp Pediatr. 2023;66(8):357-365.   Published online June 14, 2023
Question: Is dyslipidemia a risk factor for asthma in children?
Finding: This was a comprehensive systematic review and retrospective multicenter study of the association between dyslipidemia and asthma in children. In a multicenter cohort analysis using the Observational Medical Outcomes Partnership Common Data Model, elevated total cholesterol levels were associated with increased risk of asthma development.
Meaning: These findings suggest an association between dyslipidemia and asthma in children.
Neurology
Need for palliative care from birth to infancy in pediatric patients with neurological diseases
Raffaele Falsaperla, Silvia Marino, Carla Moscheo, Lucia Giovanna Tardino, Simona Domenica Marino, Concetta Sciuto, Piero Pavone, Giovanna Vitaliti, Federica Sullo, Martino Ruggieri
Clin Exp Pediatr. 2023;66(8):350-356.   Published online June 14, 2023
Question: What are the current palliative care protocols, palliative course, and implementable palliative care programs for hospitalized pediatric patients with neurological diseases in Italy?
Finding: We studied 34 newborns with nervous system diseases, all of whom had a poor prognosis.
Meaning: Despite current legislation in Italy, no palliative care network has been implemented. Given the vast number of patients with neurological conditions, standardized palliative care guidelines and protocols are required.
Editorial
Cardiology
Arrhythmias in pediatric patients with COVID-19
Ji-Eun Ban
Clin Exp Pediatr. 2023;66(8):348-349.   Published online June 14, 2023
· Childrens with coronavirus disease 2019 less commonly display life-threatening arrhythmias, including premature atrial or ventricular beats, or conduction disturbances such as first-degree atrioventricular blocks.
· Life-threatening arrhythmias (e.g., nonsustained or sustained ventricular tachycardia, atrial tachycardia, atrial fibrillation, complete atrioventricular block) occur in children with sudden acute respiratory syndrome coronavirus-2 infection suffering from myocarditis or multisystem inflammatory syndrome in children (MIS-C).
· Monitoring clinical status and assessing and managing arrhythmias are crucial in MIS-C.
Review Article
Allergy
Trends of vitamin D in asthma in the pediatric population for two decades: a systematic review
Myongsoon Sung
Clin Exp Pediatr. 2023;66(8):339-347.   Published online June 14, 2023
· Vitamin D may affect asthma via multiple mechanisms, including lung and optimal immune system functions.
· Many clinical trials have demonstrated the beneficial effects of vitamin D on asthma onset and aggravation. However, definitive clinical trials are lacking, and reports have detailed contradictory effects of vitamin D in children with asthma.
· Some exciting reports stated that obesity and vitamin D deficiency are associated with increased asthma symptoms in the pediatric population.
Cardiology
Environmental changes surrounding congenital heart disease
Eun-Young Choi
Clin Exp Pediatr. 2023;66(8):332-338.   Published online January 2, 2023
· As the number of patients with congenital heart disease increases, the medical burden increases.
· Various fusion imaging techniques using percutaneous procedures have been introduced.
· With advances in technology, convenient ambulatory devices have been introduced.
· A well-organized team approach is required to resolve advanced heart failure in patients with congenital heart disease.
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.
Letter to the Editor
Infection
Chest x-ray findings in children with COVID-19: lesson learned from referral hospitals in Medan, North Sumatera, Indonesia
Andrew Limavady, Eka Airlangga, Ririe Fachrina Malisie, Ayodhia Pitaloka Pasaribu
Clin Exp Pediatr. 2023;66(7):317-319.   Published online May 16, 2023
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.
Gastroenterology
Assessing indicators and clinical differences between functional and organic childhood constipation: a retrospective study in pediatric gastroenterology clinics
Hasan M. Isa, Fatema A. Alkharsi, Fatema A. Salman, Maryam S. Ali, Zahra K. Abdulnabibi, Afaf M. Mohamed
Clin Exp Pediatr. 2023;66(7):296-306.   Published online June 14, 2023
Question: What causes childhood constipation, and what can predict organic constipation?
Finding: Constipation represents 14.7% of gastroenterology visits. Functional constipation is more common among constipation types, while organic constipation is more common in young children and those with a low body weight, stunted growth, mucus in the stool, and associated diseases.
Meaning: Younger children and those with lower growth or mucus in the stool should be assessed for underlying organic causes of constipation.
Editorial
Gastroenterology
Gut microbiota’s impact on obesity
Sujin Jeong
Clin Exp Pediatr. 2023;66(7):294-295.   Published online June 14, 2023
· An imbalance of the gut microbiota with a relative increase in Firmicutes versus Bacteroidetes is associated with the pathogenesis of obesity.
· Dysbiosis is associated with microbial genes associated with short-chain fatty acids (SCFA) production and increased colonic SCFA levels. SCFAs have also been shown to regulate appetite and satiety hormones, which can affect food intake and energy balance.
· A dietary high-fat intake is reportedly associated with increased plasma lipopolysaccharide. Altered Toll-like receptor-4 signaling leads to propagating the cascade of further inflammation and promoting insulin resistance.
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.
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
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.
Letter to the Editor
Developmental and Behavioral Medicine
Effect of rolling over pattern and caregiver perception on plagiocephaly in Korean infants
Jin A Yoon, Soo-Yeon Kim, Yong Beom Shin
Clin Exp Pediatr. 2023;66(6):272-273.   Published online May 24, 2023
Original Article
Neonatology (Perinatology)
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.
Developmental and Behavioral Medicine
Parenting stress and interactive engagement behaviors in children with developmental delay
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
· 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.
Editorial
Gastroenterology
Recent advances in epigenetic mechanisms, diagnosis, and treatment of pediatric gastrointestinal allergic disorders
Eell Ryoo
Clin Exp Pediatr. 2023;66(6):250-251.   Published online May 19, 2023
· Epigenetic mechanisms are involved in rapidly increasing food allergy.
· There is still no definitive way to diagnose food allergy.
· Early introduction of peanuts, eggs, and cow’s milk reduces food allergy incidence.
· Administration of probiotics such as Lactobacillus rhamnosus GG, Bifidobacterium bifidum can partially reduce the occurrence of allergic symptoms.
Review Article
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.
Role of social media use in onset of functional gastrointestinal disorders in children
Mauro Cinquetti, Vanessa Dargenio, Michele Fingerle, Carolina Marchiotto, Marco Biasin, Massimo Pettoello Mantovani, Flavia Indrio
Clin Exp Pediatr. 2023;66(6):226-232.   Published online December 21, 2022
· Social media use can cause adverse health outcomes, including gastrointestinal disorders, in children and adolescents.
· Recent findings have shown a high prevalence of social media use and decreased well-being in patients with functional gastrointestinal disorders.
· The biopsychosocial nature of functional gastrointestinal disorders and the clear influence of social media on the psychosocial lives of children suggests the likely involvement of social media in their development.
Clinical Note
Other
Novel PTRH2 gene variant causing IMNEPD (infantile-onset multisystem neurologic, endocrine, and pancreatic disease) in 2 Saudi siblings
Dalal K. Bubshait
Clin Exp Pediatr. 2023;66(5):223-225.   Published online March 23, 2023
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.
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