Clinical and Experimental Pediatrics

Perspective

Other

Telemedicine in pediatrics: things to consider

Sandhya J. Kadam, Archana Reddy Bongurala

Clin Exp Pediatr. 2025;68(4):326-328. Published online February 3, 2025

This article highlights the benefits, challenges, and current significance of telemedicine. Future research is needed, primarily to address the challenges of optimizing the implementation of telehealth. To use telemedicine effectively and efficiently for the timely diagnosis and management of patients, an evaluation of current telemedicine practice is needed. Analysis of shortcomings and advantages can help enhance healthcare delivery to pediatric patients, making it more accessible for future use.

DOI: https://doi.org/10.3345/cep.2024.01788

Original Article

Pulmonology

Impact of obesity on pulmonary function of preschool children: an impulse oscillometry study

Anuvat Klubdaeng, Kanokporn Udomittipong, Apinya Palamit, Pawinee Charoensittisup, Khunphon Mahoran

Clin Exp Pediatr. 2025;68(4):319-325. Published online November 13, 2024

Question: Does obesity in preschool children affect lung function, and which obesity indices can predict such alterations?
Finding: Preschool children with obesity exhibit impaired lung function characterized by elevated total and peripheral airway resistance. Waist-to-height ratio was the strongest predictor of such changes.
Meaning: Early obesity prevention and treatment are needed. Monitoring waist-to-height ratio, body weight, and body mass index may help identify children at risk of altered lung function.

DOI: https://doi.org/10.3345/cep.2024.01053

Nephrology (Genitourinary)

C3 glomerulopathy in children: experience at a resource-limited center

Soumya Reddy, Abhishek Ghante, Mahesha Vankalakunti, Anil Vasudevan

Clin Exp Pediatr. 2025;68(4):311-318. Published online November 28, 2024

Question: What are the clinicopathological features and outcomes of pediatric C3 glomerulopathy (C3G) in resource-limited settings?
Finding: Children with C3G in resource-limited settings have significant morbidities, and most experience kidney sequelae despite treatment. Electron microscopy was performed in only 50% of our patients, while none received complement assays or genetic testing.
Meaning: Pediatric C3G presentation, management, and kidney outcomes vary. Its thorough evaluation and management are challenging in resource-limited settings.

DOI: https://doi.org/10.3345/cep.2024.01256

Neurology

Occurrence of stroke in children and young adults in Indonesia: a multicenter private hospital study

Jeanne Leman, Veli Sungono, Yosua Timotius Haryono, Muhammad Adam Mudzakir, Dewi Lestari Rahmawati, Callistus Bruce Henfry Sulay, Gilbert Sterling Octavius

Clin Exp Pediatr. 2025;68(4):303-310. Published online November 13, 2024

Question: What is the occurrence of pediatric stroke in Indonesia?
Finding: This multicenter study identified 1,074 stroke cases, predominantly hemorrhagic (83.4%), with males and older children at higher risk. Accidents were the primary cause (73.2%).
Meaning: Pediatric stroke in Indonesia shows critical epidemiological trends, highlighting the need for targeted prevention efforts, particularly for high-risk groups like males and accident victims.

DOI: https://doi.org/10.3345/cep.2024.01214

Editorial

General Pediatrics

Global breastfeeding efforts: a long way to go

Hye-Jung Shin

Clin Exp Pediatr. 2025;68(4):300-302. Published online November 13, 2024

· Despite much effort, breastfeeding practices remain unsatisfactory worldwide.
· Effective breastfeeding-promoting interventions are needed that are appropriate for age, culture, and social environment.
· Interventions can promote breastfeeding, especially in younger populations such as adolescent mothers.

DOI: https://doi.org/10.3345/cep.2024.01361

Neonatology (Perinatology)

Advancements and challenges in neonatal resuscitation: embracing laryngeal mask airways for improved outcomes

Jang Hoon Lee

Clin Exp Pediatr. 2025;68(4):298-299. Published online November 28, 2024

Positive pressure ventilation (PPV) is the most critical intervention provided during delivery room resuscitation. In the new guidelines, this recommendation has been expanded to suggest the use of laryngeal mask airyway (LMA) versus face masks for PPV. Evidence-based information and hands-on training related to this practice will help more healthcare providers become familiar with and appropriately use LMA during delivery room resuscitations.

DOI: https://doi.org/10.3345/cep.2024.01088

Review Article

Neonatology (Perinatology)

Recent advances in understanding pathophysiology of non-nutritional stunting in very preterm infants

Eduardo Cuestas, Alina Rizzotti

Clin Exp Pediatr. 2025;68(4):287-297. Published online December 23, 2024

· Previous reviews of extrauterine growth restriction focused mainly on weight growth restriction caused by nutritional factors or pathological conditions.
· This review summarizes recent developments in the pathophysiology of nonnutritional length growth restriction in very preterm infants with focus on the impact of sustained neonatal inflammation on their short- and long-term outcomes.
· Further research is needed to investigate optimal strategies to improve length growth restriction in very preterm infants.

DOI: https://doi.org/10.3345/cep.2024.01354

Cardiology

Lifelong impact of elevated blood pressure from childhood to adulthood

Junhyun Kwon, Eunji Kim

Clin Exp Pediatr. 2025;68(4):278-286. Published online November 28, 2024

· Childhood blood pressure (BP) is significantly associated with adult hypertension and cardiovascular disease.
· Despite ongoing debate regarding the need for regular BP screening and early pharmacotherapy in children, the benefits of optimizing BP throughout childhood are clear.
· Childhood presents a critical window for normalizing BP through lifestyle modifications such as reducing sodium intake and increasing physical activity to promote lifelong cardiovascular health and prevent longterm complications.

DOI: https://doi.org/10.3345/cep.2024.01445

Neurology

Cerebral organoid research for pediatric patients with neurological disorders

Jin Eun, Jung Eun Lee, Seung Ho Yang

Clin Exp Pediatr. 2025;68(4):269-277. Published online November 28, 2024

Cerebral organoids obtained from human induced pluripotent stem cells are transforming the study of pediatric neurological diseases by providing more accurate models of human brain development and pathology. These advancements have improved pathology modeling and the potential for novel therapeutic approaches despite existing challenges such as reproducibility and vascularization.

DOI: https://doi.org/10.3345/cep.2024.01235

Clinical Note

Gastroenterology

Congenital antral web: rare cause of gastric outlet obstruction successfully managed with endoscopic balloon dilatation

Upasana Ghosh, Ujjal Poddar, Srinivas Srinidhi Vadlapudi, Moinak Sen Sarma, Anshu Srivastava

Clin Exp Pediatr. 2025;68(3):266-268. Published online January 13, 2025

DOI: https://doi.org/10.3345/cep.2024.01242

Original Article

Genetics and Metabolism

Long-term follow-up of neurocognitive function in patients with citrin deficiency and cholestasis

Meng-Ju Melody Tsai, Jung-Chi Chang, Heng-Yu Lu, Susan Shur-Fen Gau, Yin-Hsiu Chien, Wuh-Liang Hwu, Yen-Hsuan Ni, Huey-Ling Chen, Ni-Chung Lee

Clin Exp Pediatr. 2025;68(3):257-265. Published online November 28, 2024

Question: Do transient metabolic disturbances in early childhood due to citrin deficiency have lasting effects on neurocognitive function?
Finding: Children with citrin deficiency have a higher prevalence of ADHD compared to the general population, with elevated ammonia levels in infancy associated with increased hyperactivity-impulsivity risk.
Meaning: Metabolic disturbances in early childhood due to citrin deficiency may contribute to long-term neurocognitive impacts, particularly ADHD, while IQ and life outcomes generally remain normal.

DOI: https://doi.org/10.3345/cep.2024.01102

Gastroenterology

Outcome of pediatric inflammatory bowel disease in Asian children: a multinational 1-year follow-up study

Pornthep Tanpowpong, Suporn Treepongkaruna, James Guoxian Huang, Kee Seang Chew, Karen Sophia Calixto Mercado, Almida Reodica, Shaman Rajindrajith, Wathsala Hathagoda, Yoko Kin Yoke Wong, Way Seah Lee, Marion Margaret Aw

Clin Exp Pediatr. 2025;68(3):247-256. Published online November 13, 2024

Question: Short-term (1-year) follow-up data in pediatric patients with inflammatory bowel disease (IBD), especially in Southeast Asian countries, are limited.
Finding/Meaning: Abdominal pain and pallor rates remained high at 1 year after IBD diagnosis. Three independent factors of 1-year clinical remission for Crohn disease were oral prednisolone, antibiotic, and immunomodulator use at 1-year follow-up. A history of weight loss at diagnosis was the only independent risk factor of IBD flare.

DOI: https://doi.org/10.3345/cep.2024.01144

Endocrinology

Prednisolone impairs trabecular bone score changes in adolescents with 21-hydroxylase deficiency

Pattara Wiromrat, Yutapong Raruenrom, Phanpaphorn Namphaisan, Nantaporn Wongsurawat, Ouyporn Panamonta, Chatlert Pongchaiyakul

Clin Exp Pediatr. 2025;68(3):238-246. Published online November 13, 2024

Crossref 1

Question: What is the prevalence of an impaired trabecular bone score (TBS), a measure of bone microarchitecture, in adolescents with 21-hydroxylase deficiency (21OHD)? Do prednisolone and hydrocortisone affect TBS differently in this patient population?
Finding: Impaired TBS was observed in 18% of participants. Prednisolone use negatively impacted TBS change.
Meaning: Impaired TBS is prevalent among adolescents with 21OHD. Prednisolone impairs trabecular bone microarchitecture development.

DOI: https://doi.org/10.3345/cep.2024.01060

General Pediatrics

Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia

Abdul Wahab, Ida Safitri Laksanawati, Retna Siwi Padmawati, Asal Wahyuni Erlin Mulyadi, Wahyu Triadmajani, Jarir At Thobari

Clin Exp Pediatr. 2025;68(3):228-237. Published online November 13, 2024

Crossref 1

Question: Do community members and health providers show different level of knowledge, attitude, and practice towards dengue vaccine?
Finding: These 2 groups only differed in practice component, while the knowledge and attitude constituents were relatively low for both.
Meaning: There is an urgent need to deliver educational interventions to raise awareness of community members and health providers regarding dengue vaccination.

DOI: https://doi.org/10.3345/cep.2024.00962

Editorial

Neonatology (Perinatology)

The predetermined future: tackling South Korea’s total fertility rate crisis

Jin Kyu Kim

Clin Exp Pediatr. 2025;68(3):225-227. Published online November 6, 2024

· South Korea faces a severe demographic crisis with the lowest global fertility rate. Despite significant investments, the total fertility rate continues to decline.
· It is necessary to fully mobilize national capabilities and execute comprehensive strategies that focus on both intangible and tangible values.
· Immediate and decisive action is essential to addressing these challenges effectively.

DOI: https://doi.org/10.3345/cep.2024.00871

Nutrition

Zinc as a treatment modality for acute infectious diarrhea in children

Ji Sook Park

Clin Exp Pediatr. 2025;68(3):223-224. Published online October 31, 2024

· Prevention and management of dehydration is the major goal of treatment in acute infectious diarrhea in children.
· Zinc could be effective as an adjuvant therapy in reducing the duration of acute infectious diarrhea in malnourished children.

DOI: https://doi.org/10.3345/cep.2024.00381

Review Article

Endocrinology

Hidden link between endocrine-disrupting chemicals and pediatric obesity

Min Won Shin, Shin-Hye Kim

Clin Exp Pediatr. 2025;68(3):199-222. Published online November 28, 2024

Studies indicate potential connections between exposure to endocrine-disrupting chemicals (EDCs) and childhood obesity. Variations in the impact of EDCs in epidemiological studies may result from differences in exposure concentrations and timing, measurement methods, and interactive effects of multiple EDCs. Longitudinal studies on exposure to multiple EDCs are crucial to elucidating their contribution to pediatric obesity and minimize the adverse health consequences of EDC exposure.

DOI: https://doi.org/10.3345/cep.2024.00556

Gastroenterology

Practical concepts and strategies for early diagnosis and management of eosinophilic gastrointestinal disorders in East-Asian children

Byung-Ho Choe

Clin Exp Pediatr. 2025;68(3):185-198. Published online November 13, 2024

Eosinophilic gastrointestinal disorders (EGIDs) often coexist with functional gastrointestinal disorders (FGIDs) and other IgE or non-IgE mediated GI diseases. Diagnosing EGIDs requires a high index of suspicion and a comprehensive approach to differentiate them from conditions like inflammatory bowel disease. Tests such as fecal calprotectin and biopsies aid in severe cases. Maintaining a food diary helps identify triggers for long-term elimination. Awareness and education are key to effective management.

DOI: https://doi.org/10.3345/cep.2024.01165

Original Article

Neonatology (Perinatology)

Effect of high-frequency oscillatory ventilation with intermittent sigh breaths on carbon dioxide levels in neonates

Kulthida Baingam, Anucha Thatrimontrichai, Manapat Praditaukrit, Gunlawadee Maneenil, Supaporn Dissaneevate

Clin Exp Pediatr. 2025;68(2):178-184. Published online November 13, 2024

Question: Can sigh breaths (Sighs) application during high-frequency oscillatory ventilation (HFOV) decrease partial pressure of carbon dioxide (PaCO₂) levels?
Finding: The mean PaCO₂ level after Sighs during HFOV was significantly decreased compared to that after HFOV alone (mean difference, -3.6 mmHg).
Meaning: HFOV plus Sighs functionality can reduce PaCO₂ levels. However, further studies are required to conclusively determine the effects of Sighs.

DOI: https://doi.org/10.3345/cep.2024.01011

Developmental and Behavioral Medicine

Characteristics of temper tantrums in 1–6-year-old children and impact on caregivers

Warangkana Prutipaisan, Issarapa Chunsuwan, Tippawan Hansakunachai, Paskorn Sritipsukho

Clin Exp Pediatr. 2025;68(2):170-177. Published online November 13, 2024

Question: What are common tantrum behaviors in preschool children, and how frequently are problematic behaviors observed? Do problematic tantrums have a different emotional impact on caregivers compared to typical tantrums?
Finding: Temper tantrums are common in preschool children, and verbal tantrums are the most common type.
Meaning: Problematic tantrums, defined as tantrums exhibiting aggressive physical behavior, long duration (>15 minutes), or frequent occurrence (>3 days/wk), significantly affected caregivers’ emotions.

DOI: https://doi.org/10.3345/cep.2024.00766

Neurology

Evaluation of pediatric migraine triggers: a single-center study

Hey-Joon Son, Joo-Ok Jin, Kon-Hee Lee

Clin Exp Pediatr. 2025;68(2):163-169. Published online November 11, 2024

Question: What are the primary triggers for pediatric migraines, and how do they impact clinical management?
Finding: Common triggers for pediatric migraines include sleep disturbances, academic stress, and motion sickness, with academic stress identified as the most intense.
Meaning: Recognizing and addressing specific triggers like sleep disturbance and academic stress is crucial to effectively managing pediatric migraines with emphasis on personalized care to improve outcomes.

DOI: https://doi.org/10.3345/cep.2024.00738

Infection

Clinical characteristics and associated factors of pediatric acute necrotizing encephalopathy: a retrospective study

Huiling Zhang, Yilong Wang, Qianyun Ding, Xuekun Li, Sheng Ye

Clin Exp Pediatr. 2025;68(2):153-162. Published online November 11, 2024

· The mortality rate of acute necrotizing encephalopathy was high.
· Laboratory tests revealed that the fatal group had higher creatinine, lactate, activated partial thromboplastin time, thrombin time, interleukin (IL)-6, IL-10, creatine kinase, and D-dimer than survivors.
· The fatal group displayed lower Glasgow Coma Scale scores and arterial pH.

DOI: https://doi.org/10.3345/cep.2024.00794

Gastroenterology

Differences in immune cells and gene expression in human milk by parity on integrated scRNA sequencing

Dae Yong Yi, Hong-Jai Park, Min Sun Shin, Hyoungsu Kim, Sang Jin Lee, Insoo Kang

Clin Exp Pediatr. 2025;68(2):141-152. Published online January 10, 2025

Question: Is there a difference in immune cells in human breast milk by parity?
Finding: There were higher proportions of monocytes and T/B cells in the primiparous and multiparous group, respectively. The expression of genes with a direct role in the infant immune system and immune response-related genes were highest in the primiparous group
Meaning: There were parity-dependent differences in the expression of genes between innate and adaptive immune cells.

DOI: https://doi.org/10.3345/cep.2024.01585

Editorial

Hematology

Absolute versus functional iron deficiency

Hye Lim Jung

Clin Exp Pediatr. 2025;68(2):138-140. Published online November 13, 2024

· Iron deficiency (ID), the most common cause of anemia, can be classified into absolute and functional types. Absolute ID is a state of low total body iron, while functional ID is a state of imbalance between iron demand and iron availability due to inflammation and/or infection.
· ID is diagnosed by serum ferritin and transferrin saturation levels.

DOI: https://doi.org/10.3345/cep.2023.01732

Allergy

Effect of metabolic syndrome on pulmonary dysfunction in children with asthma

Hyo-Bin Kim

Clin Exp Pediatr. 2025;68(2):136-137. Published online November 13, 2024

· The prevalence of metabolic syndrome increased in Korean children during the coronavirus disease 2019 pandemic owing to reduced physical activity resulting from social distancing.
· Metabolic syndrome impacts pulmonary dysfunction in childhood asthma.
· Further studies are needed to understand the mechanism linking asthma and metabolic syndrome and develop interventions.

DOI: https://doi.org/10.3345/cep.2024.00360

Review Article

Gastroenterology

Value of transabdominal ultrasonography for diagnosing functional constipation in children: a systematic review and meta-analysis

Duc Long Tran, Phu Nguyen Trong Tran, Paweena Susantitaphong, Phichayut Phinyo, Palittiya Sintusek

Clin Exp Pediatr. 2025;68(2):127-135. Published online November 13, 2024

Transabdominal ultrasonography is increasingly used as a novel modality for detecting pediatric functional constipation (FC). This systematic review and metaanalysis aimed to assess the diagnostic parameters of FC including rectal diameter (RD) and anterior rectal wall thickness. A systematic search was conducted of the Ovid MEDLINE, Embase, Scopus, and PubMed databases through September 29, 2023, to identify studies comparing RD...

DOI: https://doi.org/10.3345/cep.2024.00927

General Pediatrics

Prevalence of childhood overweight and obesity in Malaysia: a systematic review and meta-analysis

Ker Yang Chua, Ker Yung Chua, Karuthan Chinna, Chooi Ling Lim, Maheeka Seneviwickrama

Clin Exp Pediatr. 2025;68(2):115-126. Published online November 13, 2024

The incidence of childhood obesity is increasing worldwide. National surveys in Malaysia have shown similar trends. This review aimed to increase our understanding of the prevalence and associated factors of childhood overweight, obesity, and excess weight in Malaysia. A systematic review and meta-analysis were conducted of studies reporting the prevalence of overweight and obesity in Malaysian children aged <18 years....

DOI: https://doi.org/10.3345/cep.2024.00899

Hematology

Promising role of voxelotor in managing sickle cell disease in children: a narrative review

Amit Agrawal, Gaurav Jadon, Japna Singh, Dalwinder Janjua

Clin Exp Pediatr. 2025;68(2):106-114. Published online November 13, 2024

Voxelotor has promising ability to increase hemoglobin levels and reduce hemolysis markers in patients with sickle cell disease (SCD). Several preclinical and phase II/III trials have demonstrated its efficacy, dose-dependent responses, and tolerability in children. Ongoing trials are assessing its safety and effectiveness in various populations, including children younger than 12 years. These findings suggest its potential as a disease-modifying drug, warranting further exploration of its role in SCD management.

DOI: https://doi.org/10.3345/cep.2024.00500

Letter to the Editor

Other

Adolescent hypertension and carotid intima-media thickness: significance of submillimetric differences

Christian Saleh

Clin Exp Pediatr. 2025;68(1):104-105. Published online November 28, 2024

DOI: https://doi.org/10.3345/cep.2024.01466

Original Article

Neurology

Instability of revised Korean Developmental Screening Test classification in first year of life

Ji Eun Jeong, You Min Kim, Na Won Lee, Gyeong Nam Kim, Jisuk Bae, Jin Kyung Kim

Clin Exp Pediatr. 2025;68(1):97-103. Published online November 11, 2024

Question: How stable are the revised Korean Developmental Screening Test score classifications in early infancy?
Finding: A significant number of infants improved into the peer and high-level group (≥-1 standard deviations), especially in the gross motor area.
Meaning: The early detection of developmental delay requires a comprehensive medical history, physical and neurological examinations, and repeated developmental screenings.

DOI: https://doi.org/10.3345/cep.2024.00619

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