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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
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
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.
Editorial
Genetics and Metabolism
Advancing orphan drug development for rare diseases
Jung Min Ko
Clin Exp Pediatr. 2024;67(7):356-357.   Published online November 17, 2023
· Rare diseases present unique challenges and unmet needs for which the development of orphan drugs tailored to them offers hope.
· Despite the hurdles posed by limited patient populations, orphan drug designations from regulatory agencies provide incentives, such as extended market exclusivity and tax credits, that ignite transformative advances.
· Scientific progress in genomics, personalized medicine, and analytics empowers precise interventions by decoding genetic anomalies and encouraging effective treatments.
Review Article
General Pediatrics
Metabolic complications of obesity in children and adolescents
Hyunjin Park, Jung Eun Choi, Seunghee Jun, Hyelim Lee, Hae Soon Kim, Hye Ah Lee, Hyesook Park
Clin Exp Pediatr. 2024;67(7):347-355.   Published online November 16, 2023
· Pediatric obesity increases the risk of metabolic complications (insulin resistance, dyslipidemia, nonalcoholic fatty liver disease) and long-term cardiovascular diseases.
· A new obesity definition and various indicators (continuous metabolic syndrome score, pediatric simple metabolic syndrome score, fatty liver index) have been proposed to evaluate children’s susceptibility to metabolic disorders.
· Laboratory and body composition tests in pediatric screenings can identify groups at high risk of metabolic complications of obesity.
Endocrinology
Association between pre- and postnatal exposure to endocrine-disrupting chemicals and birth and neurodevelopmental outcomes: an extensive review
Ozge Yesildemir, Mensure Nur Celik
Clin Exp Pediatr. 2024;67(7):328-346.   Published online November 16, 2023
· Sensitivity to endocrine-disrupting chemical (EDC) exposure increases during critical developmental periods (in embryos, fetuses, and neonates).
· Pre- and postnatal exposure to EDCs is associated with fetal growth restriction, preterm birth, and low birth weight.
· Exposure to EDCs during fetal and early postnatal life can have lasting and lifelong neurodevelopmental outcomes, including autism spectrum, attention deficit hyperactivity, and other cognitive and behavioral disorders.
Genetics and Metabolism
Development of orphan drugs for rare diseases
Han-Wook Yoo
Clin Exp Pediatr. 2024;67(7):315-327.   Published online June 28, 2023
· Orphan disease is a rare disease, primarily affecting newborn and children. Vast majority of orphan diseases has genetic background.
· Orphan disease is individually rare. But as a whole, it is not rare, becoming a great socioeconomic burden.
· The diagnosis of rare genetic disease has been problematic, but recent progress of genome analysis technologies makes it faster and more precise.
· There are many unmet needs as to the curative treatment. However, the number of treatable rare diseases is growingly increasing owing to the development of biotechnology.
· Most orphan drugs are extremely expensive because of numer ous hurdles during the process of drug development as well as small number of patients.
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
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
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.
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
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.
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.
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
· 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.
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
· 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.
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
· 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.
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
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.
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.
Editorial
Neonatology (Perinatology)
Exploring the role of laryngeal masks in neonatal resuscitation
Euiseok Jung
Clin Exp Pediatr. 2024;67(5):247-248.   Published online December 28, 2023
· Laryngeal masks (LMs) offer stable airway access and skill retention advantages, making them promising alternatives to positive-pressure ventilation in neonatal care.
· The ease of teaching LM insertion techniques to less experienced providers addresses the need for swift intervention and skill retention.
· Careful consideration of the benefits and challenges of LMs is essential in determining their effective integration into enhanced neonatal resuscitation protocols.
Review Article
Neonatology (Perinatology)
Updates in neonatal resuscitation: routine use of laryngeal masks as an alternative to face masks
Eun Song Song, Ga Won Jeon
Clin Exp Pediatr. 2024;67(5):240-246.   Published online July 11, 2023
In neonatal resuscitation:
· Laryngeal masks are recommended when endotracheal intubation or positive-pressure ventilation fails.
· Laryngeal masks are useful even during chest compressions.
· Laryngeal masks aid neonates >34 weeks’ gestation and/or with a birth weight >2 kg.
· Main usage barriers include limited experience (81%), preference for endotracheal tubes (57%), and lack of awareness (56%).
· Second-generation laryngeal masks have a built-in esophageal drainage tube that prevents regurgitation into the glottis, and an orogastric tube can be inserted within the esophageal drainage tube to protect against gastric inflation.
Other
Children’s health affected by parent’s behavioral characteristics: a review
Sung Eun Kim, Jongin Lee
Clin Exp Pediatr. 2024;67(5):232-239.   Published online August 21, 2023
· Parents’ occupational hazards, long working hours, and smoking behaviors should be modified adequately to minimize adverse health effects on their children.
· As of 2023, several diseases from fetal exposure to occupational hazards can be compensated with Industrial Accident Compensation Insurance in South Korea.
· A directed acyclic graph is recommended for medical research to control the effects of parents’ behaviors on children’s health.
Neonatology (Perinatology)
Influence of infant microbiome on health and development
Noelle Younge
Clin Exp Pediatr. 2024;67(5):224-231.   Published online August 21, 2023
· The infant gut microbiome is highly dynamic and individualized.
· Microbes are vertically transmitted from mother to infant during delivery and throughout infancy.
· Delivery mode, gestational age, diet, and antibiotic use influence infant microbiome composition and function.
· In animal studies, the microbiome played critical roles in the structural and functional development of the infant gastrointestinal and immune systems.
· Microbiome-targeted therapies have great potential to reduce infant morbidity and mortality.
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
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
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.
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
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.
Editorial
Allergy
Trends in food allergen immunotherapy in Korea after changed national regulations
Tae Won Song
Clin Exp Pediatr. 2024;67(4):201-202.   Published online November 21, 2023
National regulations, academic guidelines, and clinical trends in food allergen immunotherapies (FA-AIT) differ among countries and have changed rapidly. Current officially approved FA-AIT are oral immunotherapy (OIT) using heated milk/egg in Korea and peanut OIT using standardized products in the United States and Europe. FA-AIT should be administered by specialist physicians with experience administering oral food challenge tests and managing severe allergic reactions inside and outside research settings.
Review Article
Nutrition
Macronutrients modified dietary intervention in the management of overweight/obese children and adolescents: a systematic review
Jihyun Park, Oh Yoen Kim
Clin Exp Pediatr. 2024;67(4):191-200.   Published online July 11, 2023
· Dietary macronutrient modifications affect the body composition of and metabolic markers in children and adolescents.
· Hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children.
· Future interventional studies with meta-analyses that include Korean children and adolescents are needed to provide basic information applicable to this population.
Cardiology
Heart failure in children and adolescents: an update on diagnostic approaches and management
Amit Agrawal, Dalwinder Janjua, Abdulrahman Ahmed Alsayed Ali Zeyada, Ahmed Taher Elsheikh
Clin Exp Pediatr. 2024;67(4):178-190.   Published online June 19, 2023
· Pediatric heart failure (PHF) is a clinical syndrome featuring various symptoms (shortness of breath, ankle swelling, fatigue) and signs (pulmonary crackles, peripheral edema).
· Congenital heart diseases are the most common underlying etiology of PHF, whereas myocarditis and primary cardio-myopathies are common in children without structural ab-normalities.
· PHF pathophysiology is complex and multifactorial and varies by etiology and age.
· PHF management includes decongestive therapy, treatment of underlying causes, preventing progression, and managing pulmonary or systemic obstructions.
· Drugs should be chosen based on pharmacodynamics, clinical manifestations, hemodynamic state, and renal function.
Neonatology (Perinatology)
Neonatal family-centered care: evidence and practice models
Juyoung Lee
Clin Exp Pediatr. 2024;67(4):171-177.   Published online June 14, 2023
· Concrete evidence exists of early parent-infant attachment supported by family-centered care (FCC) in the neonatal intensive care unit.
· FCC involves the parents’ presence and participation in the infant’s care and decision-making.
· A private and comfortable space should be provided. A single-family room is ideal; however, a quiet space with a recliner can be a good alternative.
· Care culture changes and staff training are required.
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
Original Article
Cardiology
Effect of face mask on pulmonary artery pressure during echocardiography in children and adolescents
Alireza Ahmadi, Mohammad Reza Sabri, Zohreh Sadat Navabi
Clin Exp Pediatr. 2024;67(3):161-167.   Published online January 23, 2024
Question: Can face masks alter pulmonary pressure in children and adolescents with and without congenital heart disease?
Findings: Mask removal during echocardiography (ECHO) reduced pulmonary pressure.
Meaning: These findings suggest that face masks should be removed during ECHO in children and adolescents.
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
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.
Editorial
Neonatology (Perinatology)
Impacts of maternal COVID-19 during pregnancy on neonatal health and epidemiology
Jae Woo Lim
Clin Exp Pediatr. 2024;67(3):149-151.   Published online December 28, 2023
Newborns born to mothers infected with coronavirus disease 2019 (COVID-19) should be closely monitored for respiratory disorders, such as transient tachypnea of the newborn, regardless of their COVID-19 test results. Further research is required of the development of infants born to mothers with COVID-19. The trends in Korea's birth rate and infant mortality rates have not been significantly affected by COVID-19.
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