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Original Article
Nutrition
Not breastfeeding and risk of autism spectrum disorders among children: a meta-analysis
Ensiyeh Jenabi, Saeid Bashirian, Amir Mohammad Salehi, Salman Khazaei
Clin Exp Pediatr. 2023;66(1):28-31.   Published online July 19, 2022
This study aimed to determine whether there is an association between not breastfeeding (versus breastfeeding) and the risk of autism spectrum disorders (ASD) among children. We found that the risk of ASD associated with not breastfeeding had an odds ratio of 1.81 (95% confidence interval, 1.35–2.27; I2=0 %). These findings suggest the importance of breastfeeding in decreasing the risk of ASD among children.
Editorial
Pulmonology
Wheezing in infants and preschoolers: phenotypes and treatment options
Jung Yeon Shim
Clin Exp Pediatr. 2023;66(1):26-27.   Published online December 6, 2022
· Knowing who will develop into asthma or who will not is important to impose proper treatment and early intervention in a child with the first episode of wheezing.
· Phenotypes of severe bronchiolitis in less than 2-year-old children with first episode of wheezing were suggested for different treatment options
· RV-induced and/or atopy-associated severe wheezing in preschool children may benefit from early intervention of asthma treatment.
Neonatology (Perinatology)
Does cord blood cortisol have a mediating effect on maternal prepregnancy body mass index and birth weight?
Gyu Hong Shim
Clin Exp Pediatr. 2023;66(1):24-25.   Published online November 30, 2022
· A high prepregnancy body mass index (pre-BMI) is associated with large for gestational age (LGA) and macrosomia, whereas a low pre-BMI is associated with small for gestational age (SGA) and low birth weight (LBW).
· The identification of the role of the hypothalamus-pituitary-adrenal axis in the effect of pre-BMI and maternal gestational weight gain on birth weight could reduce the frequency of LGA, macrosomia, SGA, or LBW through maternal diet optimization.
Pulmonology
Community-acquired pneumonia in Korean children: time to read between the lines
Dong In Suh
Clin Exp Pediatr. 2023;66(1):22-23.   Published online November 10, 2022
· Various studies have reported the etiology of community-acquired pneumonia (CAP) in Korean children
· Factors other than etiology are equally important to a compre hensive understanding of CAP
· Knowledge from archived reports is no longer directly applicable to the current CAP and requires careful modification
Review Article
Gastroenterology
Current diagnosis and image-guided reduction for intussusception in children
Jisun Hwang, Hee Mang Yoon, Pyeong Hwa Kim, Ah Young Jung, Jin Seong Lee, Young Ah Cho
Clin Exp Pediatr. 2023;66(1):12-21.   Published online July 4, 2022
· Intussusception, the most common cause of small bowel obstruction in young children, has an overall incidence in Korea of 28.3 cases per 100,000 person-years.
· Its cause is idiopathic inmost cases, although viral or bacterial gastroenteritis has beenpostulated as a cause. Approximately 4% of children have pathological lead points for intussusception, and Meckel’s diverticulum is the most common cause.
· Intussusception in preterm infants is extremely rare. Older children (>5 years of age) are at increased risk of pathological lead points.
Cardiology
Research trends on causes of Kawasaki disease in the COVID-19 era: focus on viral infections
Young Hwan Lee
Clin Exp Pediatr. 2023;66(1):1-11.   Published online June 22, 2022
· The etiology of Kawasaki disease (KD) is unclear, but its clinical, epidemiological, and pathophysiological characteristics are strongly associated with infectious diseases.
· In the coronavirus disease 2019 pandemic era, viruses are attracting the most attention. Sudden acute respiratory syndrome coronavirus 2 infection causes various hyperinflammation in children that require differentiation from KD.
· Immune responses in patients with KD may be induced by host cell damage. To effectively prevent and treat KD, the genetic background and immune responses of KD patients and triggering pathogens require identification.
Clinical Note
Endocrinology
Graves’ disease: an uncommon cause of late sequelae following DRESS (drug reaction with eosinophilia and systemic symptoms)
Therdpong Tempark, Amatanun Tangthanapalakul, Tawatchai Deekajorndech, Susheera Chatproedprai, Vichit Supornsilchai, Siriwan Wananukul
Clin Exp Pediatr. 2022;65(12):602-604.   Published online June 22, 2022
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.
Editorial
Allergy
Clinical considerations and practical issues of allergic diseases in COVID-19 era
Sungsu Jung
Clin Exp Pediatr. 2022;65(12):587-588.   Published online November 29, 2022
The risk of sudden acute respiratory syndrome coronavirus 2 infection and severe coronavirus disease 2019 (COVID-19) outcomes is not elevated in patients with the type 2 phenotype and well-controlled asthma. Inhaled corticosteroids, intranasal corticosteroids, and topical steroids can be safely used in COVID-19 patients. Biologics can be safely used by patients with allergic diseases without concern about antibody responses.
Gastroenterology
Ability of probiotics to reduce functional abdominal pain in children
Ji Sook Park
Clin Exp Pediatr. 2022;65(12):585-586.   Published online October 6, 2022
· The ability of probiotics to relieve pain caused by functional abdominal pain disorders (FAPD) in children is unclear.
· Lactobacillus reuteri may effectively reduce pain caused by childhood FAPD.
· Since the routine use of probiotics cannot be recommended due to a lack of clinical evidence, research into probiotic mixtures or symbiotics remains necessary.
Review Article
Allergy
Diagnosis and management of asthma in infants and preschoolers
Hai Lee Chung
Clin Exp Pediatr. 2022;65(12):574-584.   Published online April 19, 2022
· Asthma in infants and preschoolers involves heterogeneous phenotypes.
· Asthma diagnosis is based on symptom patterns, therapeutic responses, and the presence of risk factors with careful consideration of differential diagnosis.
· Daily inhaled corticosteroid therapy remains the most effective strategy for managing persistent asthma symptoms irrespective of phenotype.
· Future research, including genetic and molecular studies, is needed to develop a clear definition of asthma and personalized therapeutic approaches.
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.
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.
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.
Nutrition
Survey of Korean pediatrician’s perceptions of barriers to and improvements in breastfeeding
Seong Phil Bae, Woo Ryoung Lee, Won-Ho Hahn, Hye-Jung Shin, Young Min Ahn, Son Moon Shin, Yong Joo Kim, Ellen Ai-Rhan Kim, Youn Jeong Shin, Dae Yong Yi, Soon Min Lee, Juyoung Lee, Jin A Lee, Sung-Hoon Chung, Euiseok Jung, Eui Kyung Choi, Ju Sun Heo
Clin Exp Pediatr. 2022;65(11):540-546.   Published online July 29, 2022
Question: What barriers to breastfeeding do Korean pediatricians perceive?
Finding: Regardless of medical institution, breastfeeding counseling for parents is currently limited, and breastfeeding is commonly discontinued due to various maternal and neonatal factors.
Meaning: To promote breastfeeding, increasing pediatrician participation in breastfeeding counseling with the establishment of appropriate breastfeeding counseling fees and the expansion of practical and high-quality breastfeeding education for medical staff should be considered.
Editorial
Cardiology
Recent research trends in Kawasaki disease-related infection
Hyang-Ok Woo
Clin Exp Pediatr. 2022;65(11):538-539.   Published online July 22, 2022
The incidence of Kawasaki disease has reportedly decreased since the coronavirus disease 2019 (COVID-19) quarantine. However, multisystem inflammatory syndrome in children has reportedly occurred more frequently in areas where COVID-19 was prevalent than in previous years. Research into the etiology of childhood and adolescent systemic vasculitis in infection-related immune responses during the COVID-19 pandemic has increased accordingly.
Neurology
Increasing our understanding of rotavirus-induced central nervous system manifestations
Jon Soo Kim
Clin Exp Pediatr. 2022;65(11):536-537.   Published online May 6, 2022
· Diverse clinicoradiological features of central nervous system (CNS) complications in rotavirus infection can be identified with the rapid and wide use of various brain magnetic resonance imaging protocols.
· An increased understanding of the various pathophysiological mechanisms of rotavirus-induced CNS manifestations will enable precise management in the future.
Review Article
Allergy
Management of patients with allergic diseases in the era of COVID-19
Eun Lee
Clin Exp Pediatr. 2022;65(11):529-535.   Published online September 23, 2022
In the early days of the coronavirus disease 2019 (COVID-19) pandemic, allergic diseases, especially asthma, were considered to be risk factors for severe COVID-19 infection, hospitalization, and death. These concerns stemmed from the idea that individuals with allergic diseases are generally more susceptible to respiratory virus infections, which are major causes of exacerbation of allergic diseases. However, epidemiologic data with...
Neonatology (Perinatology)
Neonatal seizures: stepping outside the comfort zone
Menna Hashish, Mohamed Reda Bassiouny
Clin Exp Pediatr. 2022;65(11):521-528.   Published online April 4, 2022
· Use conventional and amplitude-integrated electroencephalography to confirm clinical seizures and screen high-risk newborns.
· Select an explicit clear elective event to be treated with less toxic and more effective antiepileptics.
General Pediatrics
Motor performance of children with attention deficit hyperactivity disorder: focus on the Bruininks-Oseretsky Test of Motor Proficiency
Khushboo Prashant Adhvaryu, Suruliraj Karthikbabu, Pratiksha Tilak Rao
Clin Exp Pediatr. 2022;65(11):512-520.   Published online February 17, 2022
· Children with attention deficit hyperactivity disorder (ADHD) tend to have impaired motor performance that may affect their growth and development.
· Although widely used among children with developmental disorders, the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP) is used sparsely among children with ADHD.
· Assessment by the BOTMP increases our understanding of the motor repertoire of children with ADHD.
· Wider usage of the BOTMP will enable more comprehensive planning of rehabilitation goals to enhance the motor abilities of children with ADHD.
Perspective
Infection
Statement on healthcare system preparedness in response to COVID-19 Omicron subvariants BA.4 and BA.5 surge in Korea from the Korean Pediatric Society and Korean Society of Pediatric Infectious Diseases
Eun Young Cho, Dong Hyun Kim, Soo-Han Choi, Ki Wook Yun, Jong Gyun Ahn, Hye-Kyung Cho, Hyunju Lee, Jina Lee, Taek-Jin Lee, Byung-Wook Eun, Jin Lee, Dae Sun Jo, Yun-Kyung Kim, Yae-Jean Kim; Committee on Infectious Diseases of the Korean Pediatric Society
Clin Exp Pediatr. 2022;65(11):510-511.   Published online September 23, 2022
In order to respond to the recent surge in coronavirus disease 2019 (COVID-19) cases and the continuously changing epidemiology of COVID-19, a sustainable and flexible pediatric healthcare system must be prepared considering the specificity of pediatric care. We demand a more proactive response from the health authorities to check the current state of pediatric COVID-19 patient care and to ensure that pediatric patients receive appropriate and timely management.
Letter to the Editor
Cardiology
Early prophylaxis of cardiomyopathy with beta-blockers and angiotensin receptor blockers in patients with Duchenne muscular dystrophy
Heirim Lee, Jinyoung Song, I-Seok Kang, June Huh, Jin A Yoon, Yong Beom Shin
Clin Exp Pediatr. 2022;65(10):507-509.   Published online August 22, 2022
Original Article
Neonatology (Perinatology)
Mediation effect of cord blood cortisol levels between maternal prepregnancy body mass index and birth weight: a hospital-based cross-sectional study
Nisanth Selvam, Jayashree K, Prasanna Mithra
Clin Exp Pediatr. 2022;65(10):500-506.   Published online July 29, 2022
Question: What is the association between cord blood cortisol and maternal weight, birth weight, and cord blood lipid profile?
Finding: Cord blood cortisol levels did not influence the relationship between maternal weight changes or birth weight. Maternal weight changes, birth weight, and cortisol levels altered the cord blood lipid profile.
Meaning: Our findings may aid United Nations Sustainable Development Goal 3 (Good Health and Well-Being) achievement by 2030.
Editorial
Neurobehavior
Impact of coronavirus disease 2019 on children’s health
Joon Won Kang
Clin Exp Pediatr. 2022;65(10):498-499.   Published online September 16, 2022
· Coronavirus disease 2019 (COVID-19) has had an enormous impact on mental health and other aspects of children’s health.
· The prevalence of anxiety, depression, and posttraumatic stress disorder in children and adolescents have increased in the COVID-19 era.
· Cooperation among parents, guardians, academic societies, and the government is needed to maintain the mental health of children and adolescents.
Other
Three-dimensional printing technolgy in orthopedic oncology
Yongsung Kim
Clin Exp Pediatr. 2022;65(10):496-497.   Published online May 11, 2022
Orthopedic oncology is one of the most active fields in applying 3-dimensional printing technology from preoperative planning to intraoperative procedures such as accurate resection of tumors and reconstruction of huge bone defects.
Nephrology (Genitourinary)
Hypertension in adulthood is programmed during the perinatal period
Min Hyun Cho
Clin Exp Pediatr. 2022;65(10):494-495.   Published online August 12, 2022
∙ Intrauterine growth restriction (IUGR) and preterm birth can be significant risk factors for the development of adult hypertension.
∙ Several perinatal factors of hypertension are related to IUGR, including renal, vascular, and rapid catch-up growth.
Review Article
Neurology
Rotavirus infection-associated central nervous system complications: clinicoradiological features and potential mechanisms
Kyung Yeon Lee
Clin Exp Pediatr. 2022;65(10):483-493.   Published online February 7, 2022
∙ Rotavirus infection-associated central nervous system (CNS) complications are fairly common in children.
∙ Common clinicoradiological features include benign convulsions with mild gastroenteritis, acute encephalopathies/encephalitis, cerebellitis, and neonatal rotavirus-associated leukoencephalopathy.
∙ Possible mechanisms for CNS complications include direct viral invasion into the brain via several potential routes such as the blood-brain barrier and vagus nerve, and entry of various brain-damaging mediators and activated immune cells into the brain.
Oncology
Application of 3-dimensional printing implants for bone tumors
Jong Woong Park, Hyun Guy Kang
Clin Exp Pediatr. 2022;65(10):476-482.   Published online December 23, 2021
∙ The application of 3-dimensional (3D) printing in orthopedic oncology is summarized into bone and tumor modeling, patient-specific instruments (PSIs), custom-made implants, and tissue engineering.
∙ The 3D-printed customized implant is the most central application, while modeling and PSI often play adjunct roles.
∙ Short-term surgical outcomes of custom-made 3D-printed implants are promising.
Neurology
Update on benign convulsions with mild gastroenteritis
Yeong Seok Lee, Ga Hee Lee, Young Se Kwon
Clin Exp Pediatr. 2022;65(10):469-475.   Published online December 27, 2021
∙ The main pathogen for benign convulsions with mild gastroenteritis (CwG) was previously rotavirus; however, cases associated with norovirus are increasing.
∙ CwG is characterized by clustered generalized seizures. Electroencephalography and magnetic resonance imaging show transiently abnormal findings in the acute phase that eventually normalize with progression. Its prognosis is good, and long-term treatment is unnecessary.
∙ There are many reports on the pathophysiological mechanism of CwG, which remains unclear.
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