Clinical and Experimental Pediatrics

Probiotics and prebiotics have strain-specific effects on the host. Synbiotics, a mixture of probiotics and prebiotics, are proposed to have more beneficial effects on the host than either agent has alone.We performed a randomized controlled trial to investigate the effect of Lactobacillus and Bifidobacterium together with oligosaccharides and lactoferrin on the development of necrotizing enterocolitis (NEC) or sepsis in very low birth weight neonates.Neonates with a gestational age ≤32 weeks and birth weight ≤1,500 g were enrolled. The study group received a combination of synbiotics and lactoferrin, whereas the control group received 1 mL of distilled water as placebo starting with the first feed until discharge. The outcome measures were the incidence of NEC stage ≥2 or late-onset cultureproven sepsis and NEC stage ≥2 or death.Mean birth weight and gestational age of the study (n=104) and the control (n=104) groups were 1,197±235 g vs. 1,151±269 g and 29±1.9 vs. 28±2.2 weeks, respectively (P>0.05). Neither the incidence of NEC stage ≥2 or death, nor the incidence of NEC stage ≥2 or late-onset culture-proven sepsis differed between the study and control groups (5.8% vs. 5.9%, P=1; 26% vs. 21.2%, P=0.51). The only significant difference was the incidence of all stages of NEC (1.9% vs. 10.6%, P=0.019).The combination of synbiotics and lactoferrin did not reduce NEC severity, sepsis, or mortality.

Ozge Serce Pehlevan

Derya Benzer

Tugba Gursoy

Guner Karatekin

Fahri Ovali

Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

益生菌联合制剂用于预防极低出生体重新生儿败血症和坏死性小肠结肠炎的随机对照试验

Mycoplasma pneumoniae (MP) is the most common cause of childhood bacterial pneumonia. Although macrolide is known to be effective as a first-line therapy, the proportion of macrolide resistance in MP pneumonia has strikingly increased during recent 2 decades in East Asia. This is challenging to physicians since they have to decide more often whether to use secondary treatment. Diagnostic methods to detect macrolide-resistance of MP are currently not available in Korean hospitals. Even in the diagnosis of MP infection, both serologic and molecular test have limitation: inability to differentiate current illness from carriage or asymptomatic infection. Combining these 2 diagnostic methods and excluding infection caused by other respiratory pathogens allow a more reliable diagnosis. This effort is even more demanding in recent years to keep children from unnecessary exposure to secondary antibiotics. Although several observational studies have reported that tetracycline and fluoroquinolone, which are considered in the treatment of refractory MP pneumonia, have efficacy of shortening the duration of fever and respiratory symptoms, those findings need to be proven by well-designed prospective studies. The use of tetracycline and fluoroquinolone in children is generally tolerable, as supported by many observational data. However, since concerns about side effects still remain, careful consideration about benefits and risks is needed to decide their use.

Hye-Kyung Cho

Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia

难治性肺炎支原体肺炎治疗决策的考量

Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur.To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors.This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017.There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipmentrelated adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028).The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.

Krittiya Chaichotjinda

Marut Chantra

Uthen Pandee

Assessment of interhospital transport care for pediatric patients

儿科患者院际转运护理评估

The increasing prevalence of pediatric obesity has emerged as a significant public health concern. Among various contributing factors, exposure to endocrine-disrupting chemicals (EDCs) has gained recognition for its potential role. EDCs, including bisphenols, phthalates, per- and polyfluoroalkyl substances, polycyclic aromatic hydrocarbons, and organochlorines, disrupt hormonal regulation and metabolic processes, contributing to alterations in fat storage, appetite regulation, and insulin sensitivity. This study offers a comprehensive review of the current research linking EDC exposure to pediatric obesity by integrating the findings from experimental and epidemiological studies. It also addresses the complexities of interpreting this evidence in the context of public health, highlighting the urgent need for further research.

Min Won Shin

Shin-Hye Kim

Hidden link between endocrine-disrupting chemicals and pediatric obesity

内分泌干扰化学物质与儿童肥胖之间的隐秘联系

Christian Saleh

Clin Exp Pediatr

Adolescent hypertension and carotid intima-media thickness: Significance of submillimetric differences: commentary on “Comparative analysis of adolescent hypertension definitions for predicting early-adulthood carotid artery intima-media thickness: Tehran

青少年高血压与颈动脉内膜-中膜厚度：亚毫米差异的意义：对“比较青少年高血压定义对预测成年早期颈动脉内膜-中膜厚度的影响：德黑兰”的评论

Jang Hoon Lee

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

新生儿复苏的进展与挑战：采用喉罩气道以改善预后

In children, C3 glomerulopathy (C3G) is a heterogeneous disease characterized by diverse clinicopathological profiles and kidney outcomes. However, diagnostic work-up in resource-limited settings is challenging because of the unavailability of complement assays and limited access to electron microscopy or genetic testing.

Soumya Reddy

Abhishek Ghante

Mahesha Vankalakunti

Anil Vasudevan

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

儿童C3肾小球病：资源有限中心的经验

Elevated blood pressure (BP) during childhood and adolescence is increasingly being recognized as a precursor to adult hypertension and cardiovascular disease (CVD). This review examines the existing evidence of the relationship between early BP elevations and long-term cardiovascular (CV) outcomes. Previous studies demonstrated a moderate association between childhood BP and adult hypertension, with early BP elevations contributing to subclinical CV changes such as left ventricular hypertrophy and increased carotid intima-media thickness as well as major premature CVD events in adulthood. However, evidence also indicates that BP normalization before adulthood may mitigate these risks, suggesting a critical interventional window before irreversible CV changes occur. Multiple modifiable and nonmodifiable factors contribute to early-life BP elevations, including genetic predisposition, a high sodium intake, obesity, sedentary behavior, and sleep disturbances. Although establishing a direct causal association between childhood BP and adult hypertension or CVD remains challenging owing to the need for long-term follow-up and large sample sizes, further research is essential to addressing the existing knowledge gaps in pediatric hypertension prevention, detection, impact, and treatment. This review highlights the importance of preventing BP elevations early in life to reduce the long-term burden of hypertension and CVD. Promoting healthy behaviors, such as maintaining a healthy weight, reducing one's sodium intake, engaging in physical activity, and ensuring adequate sleep, is essential for managing BP at an early age. These efforts reduce individual CV risk and help alleviate the broader future public health burden of hypertension and CVD.

Junhyun Kwon

Eunji Kim

Lifelong impact of elevated blood pressure from childhood to adulthood

从儿童到成年期高血压的终身影响

Abbreviation	Clin Exp Pediatr
Journal Impact	3.13
Quartiles(Global)	PEDIATRICS(Q1)

ISSN	2713-4148
h-index	41

Publication Information	Publisher: Korean Pediatric Society，Publishing cycle: ，Journal Type: journal，Open Access Journals: Yes
Basic data	Year of publication: 2020，Proportion of original research papers: 38.10%，Self Citation Rate:6.20%， Gold OA Rate: 100.00%
Average review cycle	60 weeks

Clinical and Experimental Pediatrics

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Synbiotics use for preventing sepsis and necrotizing enterocolitis in very low birth weight neonates: a randomized controlled trial

Consideration in treatment decisions for refractory Mycoplasma pneumoniae pneumonia

Assessment of interhospital transport care for pediatric patients

Hidden link between endocrine-disrupting chemicals and pediatric obesity

Adolescent hypertension and carotid intima-media thickness: Significance of submillimetric differences: commentary on “Comparative analysis of adolescent hypertension definitions for predicting early-adulthood carotid artery intima-media thickness: Tehran

Hidden link between endocrine-disrupting chemicals and pediatric obesity

Adolescent hypertension and carotid intima-media thickness: Significance of submillimetric differences: commentary on “Comparative analysis of adolescent hypertension definitions for predicting early-adulthood carotid artery intima-media thickness: Tehran

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

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

Lifelong impact of elevated blood pressure from childhood to adulthood