Article 63(10); Oct 2020
Review Articles
Allergy
Montelukast use over the past 20 years: monitoring of its effects and safety issues
Yong Ju Lee, Chang-Keun Kim
Clin Exp Pediatr. 2020;63(10):376-381.   Published online February 5, 2020
Although the efficacy of montelukast is inferior to that of ICS, both physicians and parents prefer montelukast to ICSs.
EDN may be a useful biomarker for the treatment and monitoring of preschool children with asthma.
The US FDA requires boxed warning about serious neuropsychiatric events of montelukast, therefore, physicians should consider the benefits and risks of montelukast before prescribing it.
Endocrinology
Air pollution and childhood obesity
Moon Young Seo, Shin-Hye Kim, Mi Jung Park
Clin Exp Pediatr. 2020;63(10):382-388.   Published online March 27, 2020
Questions: What are the possible effects of air pollution on the occurrence of childhood obesity and what are the mechanisms?
Finding: Epidemiologic studies suggest that air pollutants might act as obesogens in the pediatric population, and their possible mechanisms include oxidative stress, physical inactivity, and epigenetic modulation.
Meaning: This paper reviews updated information on air pollution, one of the modifiable environmental factors in childhood obesity.
Editorials
Allergy
Should we prescribe montelukast to allergic pediatric patients?
Yong Mean Park
Clin Exp Pediatr. 2020;63(10):389-390.   Published online August 24, 2020
Neonatology (Perinatology)
Risk factors for in-hospital mortality in premature infants with critical congenital heart disease
Jeonghee Shin
Clin Exp Pediatr. 2020;63(10):391-392.   Published online October 6, 2020
The incidence and mortality rates of critical congenital heart disease (CHD) are higher in preterm than in term infants. The risk factors for in-hospital mortality in premature infants with critical CHD are unclear. However, the mortality of preterm infants with critical CHD may be related to CHD complexity as well as gestational age, birth weight, the presence of prematurity-associated comorbidities, and the treatment itself.
Utility of neonatal early-onset sepsis calculator in risk-based group B Streptococcus screening approach
Myo-Jing Kim
Clin Exp Pediatr. 2020;63(10):393-394.   Published online May 22, 2020
· Evaluation of the risk factors for early-onset sepsis (EOS) is important to optimal prevention and treatment.
· The EOS calculator is still valid as part of the risk-based group B Streptococcus (GBS) screening approach.
· The risk factor assessment using the EOS calculator is worth use before the introduction of universal GBS screening.
Original Articles
Neonatology (Perinatology)
New modified version of the Risk Adjustment for Congenital Heart Surgery category and mortality in premature infants with critical congenital heart disease
Young Mi Yoon, Seong Phil Bae, Yoon-Joo Kim, Jae Gun Kwak, Woong-Han Kim, Mi Kyoung Song, Seung Han Shin, Ee-Kyung Kim, Han-Suk Kim
Clin Exp Pediatr. 2020;63(10):395-401.   Published online July 15, 2020
Questions: This study aimed to describe the survival of premature infants with critical congenital heart disease (CHD) and to identify the risk factors including the new modified version of the Risk Adjustment for Congenital Heart Surgery (M-RACHS) associated with mortality.
Finding: For premature infants with critical CHD, survival rate was 76.9% and very low birth weight (VLBW), persistent pulmonary hypertension of the newborn (PPHN), bronchopulmonary dysplasia (BPD), and M-RACHS 5 or more were associated with in-hospital mortality.
Meaning: VLBW, PPHN and BPD, as well as M-RACHS≥5, were risk factors for mortality among premature infants with critical CHD.
Endocrinology
Zinc transporter 8 autoantibody in the diagnosis of type 1 diabetes in children
Nur Rochmah, Muhammad Faizi, Siti Wahyu Windarti
Clin Exp Pediatr. 2020;63(10):402-405.   Published online October 6, 2020
Question: Can zinc transporter 8 autoantibody (ZnT8A) be used for diagnosing type 1 diabetes (T1D)?
Finding: Twenty-two of 30 subjects with type 1 diabetes (73.3 %) were positive for ZnT8A compared to 5 of 18 controls (27.8%).
Meaning: ZnT8A has potential for clinical applications in the diagnosis of T1D.
Neonatology (Perinatology)
Risk-based maternal group B Streptococcus screening strategy is compatible with the implementation of neonatal early-onset sepsis calculator
Niek B. Achten, J. Wendelien Dorigo-Zetsma, Annemarie M.C. van Rossum, Rianne Oostenbrink, Frans B. Plötz
Clin Exp Pediatr. 2020;63(10):406-410.   Published online April 16, 2020
Question: To what extent does risk-based Group B Streptococcus (GBS) screening influence management recommendations by the early-onset sepsis (EOS) calculator?
Finding: In 97% of the newborn infants, the EOS calculator recommendation remained unchanged after the GBS status at birth was updated to the definitive GBS status.
Meaning: Risk-based GBS screening results are compatible with EOS calculator recommendations.
Clinical Note
Nephrology (Genitourinary)
First episode of nephrotic syndrome with acute abdominal pain
Samridhi Goyal, Rachita Singh Dhull, Bobbity Deepthi, Abhijeet Saha
Clin Exp Pediatr. 2020;63(10):411-414.   Published online July 21, 2020
Question: What are the likely causes of pain abdomen in Nephrotic syndrome?
Finding: Severe hypovolemia leading to mesenteric ischemia, spontaneous bacterial peritonitis, gastroenteritis, adverse effect of corticosteroids leading to gastritis, mesenteric ischemia due to thromboembolism, acute appendicitis, intussusception due to severe gut wall oedema and rarely Psoas abscess.
Meaning: Clinical suspicion and careful investigation is warranted to diagnose rare cause of pain abdomen like Psoas abscess.
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