Trends in food allergen immunotherapy in Korea after changed national regulations
Clinical and Experimental Pediatrics.2024;67(4):201-202. doi:10.3345/cep.2023.01123
Clinical and Experimental Pediatrics
2002 (v1, n1) to Present ISSN: 1671-8925
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Clinical and Experimental Pediatrics.2024;67(4):221-223. doi:10.3345/cep.2023.01445
Neonatal family-centered care: evidence and practice models
Clinical and Experimental Pediatrics.2024;67(4):171-177. doi:10.3345/cep.2023.00367
Although advances in neonatology have reduced the mortality rate of high-risk infants, sick newborns or pre-mature infants undergo more intensive monitoring, pain-ful procedures, and lengthy hospitalization, leading to pro-longed separation from their parents. In recent decades, the importance of parent-infant closeness early in life has become more apparent, especially in preterm infants who are prone to neurodevelopmental deficits. There is an increasing body of evidence regarding the benefits of family-centered care (FCC) in neonatal intensive care units. Key aspects related to neonatal FCC include the parents’ presence in the ward and their participation in infants’ daily care and decision-making processes. In addition, an environment that supports a private and comfortable space for each family member and infant, such as a single-family room, should be provided. To successfully implement FCC in neonatal intensive care units, the culture of care and hospital policies should be changed to successfully implement FCC in neonatal intensive care units, and appropriate training for medical staff is also required.
Heart failure in children and adolescents: an update on diagnostic approaches and management
Clinical and Experimental Pediatrics.2024;67(4):178-190. doi:10.3345/cep.2023.00528
Cardiac failure is a clinical syndrome that may develop in children owing to cardiac dysfunction or underlying structural heart diseases. Considering the differences in diagnostic and therapeutic approaches for pediatric heart failure (PHF) and adult heart failure, we have reviewed the current literature on PHF. Relevant studies were extracted from MEDLINE/PubMed, Google Scholar, and Clinical Trial Registries using the terms “pediatric heart failure” or “heart failure in children” and “management” or “decongestive therapy.” Recent advances in diagnostic approaches, such as cardiac magnetic resonance, speckle-tracking echocardiography, tissue Doppler imaging, and molecular diagnostic techniques, have increased our under -standing of PHF. It is imperative that clinicians evaluate the interrelated factors responsible for the develop ment of PHF, including myocardial function, pulmonary and systemic blood flow, heart rhythm, valve function, and nutritional status. Although recent advances have demon strated the efficacy of many new drugs in adult heart failure trials, it cannot be concluded that these drugs will show similar efficacy in children, considering the heterogeneous nature of the underlying mechanisms and variable pharmacody-namics and pharmacokinetics. Therefore, the underlying pathophysiology of PHF and the mechanisms of action of different drugs should be considered when selecting appropriate therapies. Further trials are needed to establi sh the efficacy and safety of these drugs, and a combined mul-ti disciplinary strategy will help enhance PHF outcomes.
Clinical and Experimental Pediatrics.2024;67(4):213-220. doi:10.3345/cep.2023.01137
Background:
Benign convulsions with mild gastroenteritis (CwG) are prevalent in young children during the winter. Early in the coronavirus disease 2019 (COVID-19) pandemic, viral gastroenteritis occurrence decreased and seasonal variation was lost, which can change CwG.Purpose: Here we investigated changes in frequency, seasonal variation, and causative viruses of CwG during the COVID-19 pandemic.
Methods:
We screened 1134 patients (3–36 months) with “other and unspecified convulsions” treated at Chonnam National University Hospital between March 2017 and February 2023; of them, we enrolled 41 (3.6%) with CwG. We compared their medical records from period I (March 2017 to February 2020) to those from period II (March 2020 to February 2023). Publicly available viral gastroenteritis surveillance data from the Korea Disease Control and Prevention Agency (KDCA) were reviewed as reference.
Results:
Of the 41 patients with CwG, 18 (2.9% of 613) were affected in period I versus 23 (4.4% of 512) in period II (P=0.184). In period I, CwG mainly occurred in winter and spring (55.6% and 22.2%, respectively). In period II, there were fewer CwG cases (39.1%) in winter and more cases in summer and autumn (26.1% and 17.4%, respectively): the cases of norovirus genogroup II (GII)-associated CwG increased significantly in the summer (38.5% vs. 0%, P= 0.046). Norovirus GII was the most common virus (56.1% of isolates). Enteric adenovirus was the second most common (19.5%), with one case in period I and 7 cases in period II (P=0.059). The clinical characteristics of enteric adenovirus-associated CwG were similar to those of norovirus. Seasonal changes in and viral causes of CwG were consistent with those observed in the KDCA stool surveillance data.
Conclusion
During the COVID-19 pandemic, CwG frequency did not change, seasonal variation was unapparent, and enteric adenovirus-associated CwG frequency increased.
Clinical and Experimental Pediatrics.2024;67(4):203-212. doi:10.3345/cep.2023.01340
Background:
Findings are conflicting regarding the effect of zinc supplementation on disease severity in children with acute gastroenteritis.Purpose: To examine the effects of probiotics and zinc on the clinical outcomes of infants and children with acute infectious diarrhea.
Methods:
In this randomized controlled trial, children with mild or moderate to severe acute gastroenteritis in the Kurdistan Region from November 2021 to June 2022 were diagnosed clinically and randomly assigned to the experimental or control group. The experimental group (n=50) received probiotics and zinc, whereas the control group (n=51) received probiotics alone for 1 week. The product contained live Bifidobacterium infantis, Lactobacillus paracasei, and Lactobacillus rhamnosus (10×106 colony-forming units/day for 7 days). Zinc syrup was administered to the probiotic plus zinc group. Each 5 mL of syrup contained 15 mg of zinc sulfate. Dehydration and disease severity in both groups were measured using the Clinical Dehydration Scale and the Modified Vesikari Scale, respectively. An illness episode was defined as an episode of gastroenteritis with a total score of ≥9 on the Modified Vesikari Scale (range, 0–20).
Results:
The probiotic and probiotic plus zinc groups were similar in age (1.79 years vs. 1.69 years, respectively; P= 0.645), sex (male/female ratio: 1.43 and 1.0, respectively; P=0.373), and medical characteristics. The groups had similar mean dehydration and disease severity scores and a similar incidence of dehydration recovery (some dehydration, 3.92% and 4.00%, respectively; P=1.000), and recovery from mild gastroenteritis (0.0% and 2.0%, respectively; P=0.495) at 2 weeks. Significant decreases in mean dehydration severity and disease severity score (1.80 to 0 and 6.66 to 0, respectively; P<0.001) and the development of dehydration (some dehydration, from 94.0% to 4.0%; P<0.001) from baseline to 2 weeks were noted in the probiotics plus zinc group. The probiotics group responded similarly. The development of mild gastroenteritis was significantly reduced from baseline to 2 weeks (90.2% to 0% and 78.0% to 2.0% in the probiotics and probiotics plus zinc groups, respectively; P<0.0001). The probiotics plus zinc group had a shorter mean recovery time (1.34 days vs. 2.00 days, respectively; P<0.001).
Conclusion
Taking probiotics plus zinc did not significantly affect disease severity in children with gastroenteritis at 2 weeks. However, the probiotics plus zinc group recovered more quickly than the probiotics group.
Clinical and Experimental Pediatrics.2024;67(4):191-200. doi:10.3345/cep.2023.00262
The prevalence of obesity in adults and children is rapidly increasing worldwide. Obesity is among the main causes of chronic diseases and various problems, including economic consequences and they can also be affected by genetic, environmental, psychological, and socioeconomic factors. Dietary modification is a well-known and important factor in weight control, in particular, dietary macronutrient composition, food selection, dietary patterns, and energy restriction can affect weight reduction. Therefore, this systematic review aims to provide basic evidence for identifying the optimal macronutrient composition for managing obesity in Korean children and adolescents. We searched literature through an international database, studies were selected using our eligibility criteria and quality was assessed via a risk of bias tool. In our results, several studies have demonstrated that dietary macronutrient modifications affect body composition and metabolic markers in children and adolescents. In contrast, hypocaloric diets, regardless of macronutrient composition, are reportedly effective for weight loss in obese children. However, these findings were based on intervention studies that examined the association between dietary macronutrient composition and obesity in non-Korean children and adolescents. Therefore, in the future, more intervention studies are needed to elucidate this relationship and evidence between macronutrients and obesity in Korean children and adolescents.
Is it possible to provide palliative care to pediatric patients with neurological diseases?
Clinical and Experimental Pediatrics.2024;67(8):403-404. doi:10.3345/cep.2023.01032
Neutropenia following metamizole use in pediatric patients: a multicenter retrospective study
Clinical and Experimental Pediatrics.2024;67(8):415-417. doi:10.3345/cep.2024.00262
Recent advances in food allergen immunotherapy
Clinical and Experimental Pediatrics.2024;67(8):386-394. doi:10.3345/cep.2023.01004
Food allergies can pose significant risks and profoundly impact the quality of life of children and their families, making them a major public health concern. Allergen avoidance has been the traditional mainstay of treatment; however, recent research has focused on various approaches to food allergen immunotherapy. This review summarizes the recent advancements in oral, sublingual, and epicutaneous immunotherapies, highlighting their respective advantages and disadvantages. The ultimate goal of food allergen immunotherapy is to maximize efficacy while minimizing risks, leading to the exploration of strategies such as low-dose immunotherapy and the use of biologics. When selecting candidates for immunotherapy among patients with food allergies, factors such as allergen characteristics, the likelihood of natural resolution, age, symptom severity, and impact on quality of life require consideration, and an individualized approach should be adopted to determine the most suitable treatment method.
Country
Republic of Korea
Publisher
Korean Pediatric Society
ElectronicLinks
http://e-cep.orgEditor-in-chief
Man Yong Han
office@e-cep.org
Abbreviation
Clin Exp Pediatr
Vernacular Journal Title
ISSN
2713-4148
EISSN
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
2020
Description
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