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Letter to the Editor
Other
Changes in air pollution and childhood respiratory viral infections in Korea post-COVID-19 outbreak
Hyung Kyu Park, Jung Yeon Shim
Clin Exp Pediatr. 2022;65(4):211-213.   Published online February 17, 2022
Clinical note
General Pediatrics
Diabetic ketoacidosis in children induced by coronavirus disease 2019 (COVID-19) diabetic ketoacidosis post-COVID-19 in children
Neha Thakur, Narendra Rai
Clin Exp Pediatr. 2022;65(4):209-210.   Published online November 30, 2021
Original Article
General Pediatrics
Early initiation of breastfeeding and factors associated with its delay among mothers at discharge from a single hospital
J. Jenifer Florence Mary, R. Sindhuri, A. Arul Kumaran, Amol R. Dongre
Clin Exp Pediatr. 2022;65(4):201-208.   Published online October 18, 2021
Background: According to the National Family Health Survey– 4, in India, 78.9% of deliveries occur in institutions, although only 42.6% of new mothers initiate breastfeeding within 1 hour of delivery.
Purpose: To estimate the proportion of early initiation of breastfeeding (EIBF) among new mothers at discharge from a tertiary care hospital and identify the determinants of delayed initiation of breastfeeding among...
Emergency Medicine
Nonfatal injuries in Korean children and adolescents, 2007–2018
Gyu Min Yeon, Yoo Rha Hong, Seom Gim Kong
Clin Exp Pediatr. 2022;65(4):194-200.   Published online September 9, 2021
Question: How many children and adolescents have experienced nonfatal injuries in the previous year?
Finding: Among Korean children and adolescents, 8.1% experienced at least one injury per year. We found no significant change in the incidence of injuries over the previous 12 years.
Meaning: The incidence of injuries is higher than this estimation; therefore, more attention and effort are needed to prevent injuries among children and adolescents.
Neonatology (Perinatology)
Comparison of minimally invasive surfactant therapy with intubation surfactant administration and extubation for treating preterm infants with respiratory distress syndrome: a randomized clinical trial
Mohammad Kazem Sabzehei, Behnaz Basiri, Maryam Shokouhi, Sajad Ghahremani, Ali Moradi
Clin Exp Pediatr. 2022;65(4):188-193.   Published online July 28, 2021
Question: Are the short-term outcomes of minimally invasive surfactant therapy (MIST) relatively superior to those of INtubation, SURfactant administration, and Extubation (INSURE) in preterm infants with respiratory distress syndrome (RDS)?
Finding: MIST could be an appropriate substitution for INSURE in preterm infants with RDS since it reduced hospitalization time and number of side effects.
Meaning: MIST is recommended for surfactant administration for its proven advantages over the INSURE technique.
Review Article
Neonatology (Perinatology)
Pathophysiology, classification, and complications of common asymptomatic thrombocytosis in newborn infants
Ga Won Jeon
Clin Exp Pediatr. 2022;65(4):182-187.   Published online October 18, 2021
· Thrombocytosis, common in newborns and infants (<2 years) (3%–13%), is caused by elevated thrombopoietin (TPO) concentrations.
· Serum TPO levels are significantly higher immediately to 1 month postnatal and decrease with age.
· Platelet counts are positively correlated with gestational age at birth and postnatal age.
· Thrombocytosis is more common in preterm than in term infants.
· Thrombocytosis in newborns is reactive and resolves spontaneously without complications.
Endocrinology
Genetic factors in precocious puberty
Young Suk Shim, Hae Sang Lee, Jin Soon Hwang
Clin Exp Pediatr. 2022;65(4):172-181.   Published online October 18, 2021
· Mutations in the kisspeptin (KISS1), kisspeptin receptor (KISS1R), makorin ring finger protein 3 (MKRN3), and delta-like homolog 1 (DLK1) genes are associated with idiopathic central precocious puberty (ICPP).
· A few genes related to pubertal onset have been implicated in ICPP.
· Epigenetic factors such as DNA methylation, histone posttranslational modifications, and noncoding ribonucleic acids may be related to ICPP
Infection
Epidemiological changes in infectious diseases during the coronavirus disease 2019 pandemic in Korea: a systematic review
Jong Gyun Ahn
Clin Exp Pediatr. 2022;65(4):167-171.   Published online November 30, 2021
· Nonpharmaceutical interventions (NPIs) have had a major impact on the epidemiology of various infectious diseases in Korea.
· Respiratory diseases and gastrointestinal viral diseases were significantly reduced during the NPI period.
· The decrease in Kawasaki disease after the introduction of NPI is an unintended result.
· Infectious diseases that decreased during NPI use may re-emerge.
· We must continuously monitor the epidemiology of various infectious diseases during the coronavirus era
Etiological and pathophysiological enigmas of severe coronavirus disease 2019, multisystem inflammatory syndrome in children, and Kawasaki disease
Jung-Woo Rhim, Jin-Han Kang, Kyung-Yil Lee
Clin Exp Pediatr. 2022;65(4):153-166.   Published online November 23, 2021
· Severe cases of coronavirus disease, Kawasaki disease (KD), and multisystem inflammatory syndrome in children (MIS-C) share similar findings: a protracted clinical course, multiorgan involvement, and similar activated biomarkers.
· Here we propose etiological agents in KD and MIS-C as species in the microbiota and introduce a common pathogenesis through the protein-homeostasis-system hypothesis.
· Early proper dose of corticosteroids and/or intravenous immunoglobulin may help to reduce morbidity and mortality in these diseases.
Correspondence and Reply
Neurobehavior
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis
Hadith Rastad, Mahnaz Seifi Alan
Clin Exp Pediatr. 2022;65(3):152-152.   Published online February 17, 2022
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis
Ensiyeh Jenabi
Clin Exp Pediatr. 2022;65(3):152-152.   Published online February 17, 2022
Letter to the Editor
Oncology
Retrospective review of severe acute respiratory syndrome coronavirus-2 infection in children with acute leukemia from a tertiary care hospital in Northern India
Suhail Chhabra, Aditya Dabas, Richa Mittal, Neha Goel, Ritabrata Roy Chowdhary, Satyendra Batra, Amitabh Singh, Rani Gera
Clin Exp Pediatr. 2022;65(3):150-151.   Published online November 26, 2021
Original Article
General Pediatrics
Gross motor dysfunction and balance impairments in children and adolescents with Down syndrome: a systematic review
Preyal D. Jain, Akshatha Nayak, Shreekanth D. Karnad, Kaiorisa N. Doctor
Clin Exp Pediatr. 2022;65(3):142-149.   Published online June 11, 2021
Question: What are the primary motor and balance dysfunctions in children with Down syndrome?
Finding: These individuals have gross delays, altered balance, and inefficient compensatory mechanisms.
Meaning: Neuromuscular and musculoskeletal impairments due to the chromosomal abnormality lead to developmental delay. These children also exhibit poor balance with greater instability and inefficient compensatory mechanisms including altered center of pressure displacement and trunk stiffening that predisposes them to falls.
Pulmonology
Modified high-flow nasal cannula for children with respiratory distress
Sarocha Itdhiamornkulchai, Aroonwan Preutthipan, Jarin Vaewpanich, Nattachai Anantasit
Clin Exp Pediatr. 2022;65(3):136-141.   Published online May 24, 2021
Question: Can the modified high-flow nasal cannula (HFNC) provide alternative respiratory support for children with acute respiratory distress?
Finding: A total of 74 patients were assigned to the modified or commercial HFNC groups. The intubation rate, length of hospital stay, and adverse events did not differ between the 2 groups.
Meaning: The modified HFNC can provide alternative respiratory support for pediatric respiratory distress.
Neonatology (Perinatology)
Is fetal nuchal cord associated with autism spectrum disorder? A meta-analysis
Ensiyeh Jenabi, Maryam Ahmadi, Azam Maleki
Clin Exp Pediatr. 2022;65(3):131-135.   Published online September 24, 2021
Question: Is fetal nuchal cord a risk factor for autism spectrum disorder (ASD)?
Finding: Five articles (1 cohort, 4 case-control; total 3,088 children) were included in the present meta-analysis. Fetal nuchal cord was not a risk factor for ASD (odds ratio, 1.11; 95% confidence interval, 0.66–1.57). There was homogeneity among studies that reported a risk of ASD (I2=0.0).
Meaning: Fetal nuchal cord is not a risk factor for ASD.
Editorial
Endocrinology
Clinical and diagnostic importance of dyslipidemia in children and adolescents during the coronavirus disease 2019 pandemic
Eun Young Kim
Clin Exp Pediatr. 2022;65(3):129-130.   Published online January 14, 2022
∙ Because childhood lipid concentrations continue into adulthood, early evaluation and treatment are needed, but dyslipidemia awareness is low.
∙ For the prevention and treatment of dyslipidemia in childhood and adolescence, a major risk factor for cardiovascular disease in adulthood, lifestyle modifications, appropriate exercise, and drug treatment are required.
∙ A large-scale study of the prevalence and therapeutic effects of dyslipidemia in children and adolescents in Korea is needed.
Infection
Importance of maintaining a high childhood vaccination rate and surveillance program against Japanese encephalitis in Korea
Su Eun Park
Clin Exp Pediatr. 2022;65(3):127-128.   Published online February 16, 2022
∙ Recent epidemiologic changes of Japanese encephalitis (JE) in Korea are area (rural to urban or suburban) and age shift (children to adult).
∙ Although the main factors contributing to recent epidemiologic changes of JE are not well identified, maintaining high vaccination rates of JE appear to be important in preventing of JE in all age groups.
∙ Continuous surveillance for epidemiology and seroprevalence should be carried out.
Review Article
Neonatology (Perinatology)
Retinopathy of prematurity: a review of epidemiology and current treatment strategies
Eun Hee Hong, Yong Un Shin, Heeyoon Cho
Clin Exp Pediatr. 2022;65(3):115-126.   Published online October 12, 2021
There have been global tri-phasic epidemic periods of retinopathy of prematurity (ROP). In recent years, its incidence has reportedly been 10%–40% depending on country and study population. Current treatment strategies for ROP include laser photocoagulation, surgical treatment, and anti-vascular endothelial growth factor treatment, the role of which has drawn attention in recent years.
Infection
Changes in age-specific seroprevalence of Japanese encephalitis virus and impact of Japanese encephalitis vaccine in Korea
Byung Ok Kwak, Young Jin Hong, Dong Hyun Kim
Clin Exp Pediatr. 2022;65(3):108-114.   Published online September 24, 2021
Since the introduction of a universal Japanese encephalitis (JE) vaccination program and urbanization, the incidence of JE has dramatically decreased in Korea. However, recent JE cases have occurred, predominantly among unvaccinated adults and with a shift in age distribution. Continuous surveillance of the seroprevalence of JE is required to establish a proper immunization policy in Korea.
Original Article
Developmental and Behavioral Medicine
Effectiveness of obesity interventions among South Korean children and adolescents and importance of the type of intervention component: a meta-analysis
Siyoung Choe, Jaesin Sa, Jean-Philippe Chaput, Deokjin Kim
Clin Exp Pediatr. 2022;65(2):98-107.   Published online November 23, 2021
Question: What is the overall effect of obesity interventions among Korean children and what affects their effectiveness?
Finding: Interventions were strongly favored over controls. Interventions including at least one physical activity component were significantly better than those that did not. Sex, age, baseline weight category, intervention duration, and the number of intervention components were not significant.
Meaning: Future obesity interventions for Korean children must seek to include physical activity components.
General Pediatrics
Effect of maternal and child factors on stunting: partial least squares structural equation modeling
Agus Santosa, Essa Novanda Arif, Dinal Abdul Ghoni
Clin Exp Pediatr. 2022;65(2):90-97.   Published online May 4, 2021
Question: What effects do maternal and child factors have on stunting? Are there significant indicators of stunting?
Finding: Child and maternal factors had 49.8% and 30.3% effects on stunting, respectively. The primary child factor was infant formula dose, while the primary maternal factor was nutritional status.
Meaning: More attention to nutritional status during pregnancy and ensuring the appropriate dose of infant formula at ages 6–24 months can prevent stunting.
Endocrinology
Association between polycystic ovary syndrome and risk of attention-deficit/hyperactivity disorder in offspring: a meta-analysis
Azam Maleki, Saeid Bashirian, Ali Reza Soltanian, Ensiyeh Jenabi, Abdollah Farhadinasab
Clin Exp Pediatr. 2022;65(2):85-89.   Published online April 15, 2021
Question: Have polycystic ovary syndrome (PCOS) increased risk of having an offspring with attention-deficit/hyperactivity disorder (ADHD)?
Finding: Six articles (3 cohort and 3 case-control studies; 401,413 total ADHD cases) met the study criteria. Maternal PCOS was associated with an increased risk of ADHD in the offspring based on odds ratio (OR) and relative ratio (RR) (OR, 1.42; 95% confidence interval [CI], 1.27–1.57) and (RR, 1.43; 95% CI, 1.35–1.51), respectively.
Meaning: Our study showed that maternal PCOS is a risk factor for ADHD.
Editorial
Allergy
Dietary restriction misconceptions and food allergy education in children with atopic dermatitis
You Hoon Jeon
Clin Exp Pediatr. 2022;65(2):83-84.   Published online January 27, 2022
∙ Food intake strategies for preventing food allergies have undergone major changes over the past 20 years.
∙ In children with atopic dermatitis, indiscriminate food restrictions without diagnostic testing leads to nutritional imbalance and poor growth.
∙ When determining food restrictions for pediatric patients with atopic dermatitis, an accurate food allergy diagnosis must be preceded, and continuous parental education about food intake is required.
Neurology
Cerebrospinal fluid biomarkers in various pediatric neurologic diseases
Jeongho Lee
Clin Exp Pediatr. 2022;65(2):81-82.   Published online January 6, 2022
Cerebrospinal fluid (CSF) has many important biomarkers that are commonly analyzed in pediatric neurologic diseases, including central nervous system infection and inflammation. Neurologic disease in pediatrics is difficult to diagnosis, there are challenges in developing CSF profiles. Some biomarkers are expected to help differential diagnosis.
Review Article
Nephrology (Genitourinary)
Blood pressure measurements and hypertension in infants, children, and adolescents: from the postmercury to mobile devices
Seon Hee Lim, Seong Heon Kim
Clin Exp Pediatr. 2022;65(2):73-80.   Published online September 15, 2021
· Hypertension is defined as a blood pressure (BP) >90th (elevated) or 95th (hypertension) percentile in children by height, age, and sex and >95th percentile in neonates by age, birth weight, and sex.
· Although the oscillometric method can be used for screenings, the auscultatory method remains the gold standard. The hybrid method employs the auscultatory and electronic methods and can reduce bias.
· BP measurement mobile device applications have a potential for development.
General Pediatrics
A new perspective on cholesterol in pediatric health: association of vitamin D metabolism, respiratory diseases, and mental health problems
Jeana Hong
Clin Exp Pediatr. 2022;65(2):65-72.   Published online December 9, 2021
∙ Pediatric dyslipidemia is associated with several health problems besides cardiovascular diseases.
∙ There is a direct association between pediatric dyslipidemia and low serum vitamin D levels, asthma, and mental health problems regardless of body mass index.
∙ More large-scale nationally representative studies are needed to establish the appropriate cutoff points for the definition of dyslipidemia that is a prerequisite for further epidemiological studies in the Korean pediatric population.
Neurology
Promising candidate cerebrospinal fluid biomarkers of seizure disorder, infection, inflammation, tumor, and traumatic brain injury in pediatric patients
Seh Hyun Kim, Soo Ahn Chae
Clin Exp Pediatr. 2022;65(2):56-64.   Published online August 23, 2021
· 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.
Letter to the Editor
Other
Evaluation of simulation-based ultrasound course for pediatricians: a starting point for future training curriculum
Chon In Kuok, Avis Siu Ha Leung, Jonan Chun Yin Lee, Winnie Kwai Yu Chan
Clin Exp Pediatr. 2022;65(1):53-55.   Published online July 28, 2021
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.
Original Article
Cardiology
Vasovagal syncope with mild versus moderate autonomic dysfunction: a 13-year single-center experience
Han Eoul Lee, Dong Won Lee
Clin Exp Pediatr. 2022;65(1):47-52.   Published online June 1, 2021
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.
General Pediatrics
Global relationship between parent and child obesity: a systematic review and meta-analysis
Ju Suk Lee, Mi Hyeon Jin, Hae Jeong Lee
Clin Exp Pediatr. 2022;65(1):35-46.   Published online March 29, 2021
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.
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