The Committee on Dyslipidemia of Korean Pediatric and Adolescents of the Korean Society of Pediatric Endocrinology has newly developed evidence-based clinical practice guidelines for dyslipidemia in Korean children and adolescents. These guidelines were formulated with the Grading of Recommendations, which include both the strength of recommendations and the quality of evidence. In the absence of sufficient evidence, conclusions were based on expert opinion. These guidelines are based on the 2011 National Heart, Lung, and Blood Institute Guidelines, which focus on the prevention of cardiovascular disease in children and draw from a comprehensive review of evidence. These guidelines contain the definition of and screening process for dyslipidemia and introduce new dietary methods: the Cardiovascular Health Integrated Lifestyle Diet (CHILD)-1, the CHILD-2-low-density lipoprotein cholesterol, and the CHILD-2-triglyceride. Potential drug therapies for dyslipidemia along with their main effects and doses were also included.

Pollen-food allergy syndrome (PFAS) is an immunoglobulin E-mediated immediate allergic reaction caused by cross-reactivity between pollen and the antigens of foods-such as fruits, vegetables, or nuts-in patients with pollen allergy. A 42.7% prevalence of PFAS in Korean pediatric patients with pollinosis was recently reported. PFAS is often called oral allergy syndrome because of mild symptoms such as itching, urticaria, and edema mainly in the lips, mouth, and pharynx that appear after food ingestion. However, reports of systemic reactions such as anaphylaxis have been increasing recently. This diversity in the degree of symptoms is related to the types of trigger foods and the characteristics of allergens, such as heat stability. When pediatric patients with pollen allergy are treated, attention should be paid to PFAS and an active effort should be made to diagnose it.

The major pathogens that cause atypical pneumonia are Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. Community-acquired pneumonia (CAP) caused by M. pneumoniae or C. pneumoniae is common in children and presents as a relatively mild and self-limiting disease. CAP due to L. pneumophila is very rare in children and progresses rapidly, with fatal outcomes if not treated early. M. pneumoniae, C. pneumoniae, and L. pneumophila have no cell walls; therefore, they do not respond to β-lactam antibiotics. Accordingly, macrolides, tetracyclines, and fluoroquinolones are the treatments of choice for atypical pneumonia. Macrolides are the first-line antibiotics used in children because of their low minimum inhibitory concentrations and high safety. The incidence of pneumonia caused by macrolide-resistant M. pneumoniae that harbors point mutations has been increasing since 2000, particularly in Korea, Japan, and China. The marked increase in macrolide-resistant M. pneumoniae pneumonia (MRMP) is partly attributed to the excessive use of macrolides. MRMP does not always lead to clinical nonresponsiveness to macrolides. Furthermore, severe complicated MRMP responds to corticosteroids without requiring a change in antibiotic. This implies that the hyper-inflammatory status of the host can induce clinically refractory pneumonia regardless of mutation. Empirical macrolide therapy in children with mild to moderate CAP, particularly during periods without M. pneumoniae epidemics, may not provide additional benefits over β-lactam monotherapy and can increase the risk of MRMP.

The childhood obesity pandemic has emerged as an important public health problem in many countries. Obese children are likely to become obese adults, and adult obesity is associated with an increased risk of morbidity. Therefore, controlling the childhood obesity epidemic has become a top public health priority worldwide. The current coronavirus disease 2019 (COVID-19) pandemic may significantly impede this important mission and constitute an unprecedented tragedy in the global battle against childhood obesity. This manuscript presents evidence that the COVID-19 pandemic will aggravate the childhood obesity epidemic and lead to significant weight gain in school children by creating an unprecedented obesogenic environment. Within the last few months, many countries took uncompromising measures in response to the COVID-19 pandemic, including school closures and quarantine. While these steps are often necessary to ensure infection control, they may have a significant negative effect on children's mental and physical health. Physical, nutritional, and psychosocial factors that promote obesity in children during this special situation complementarily contribute to an unprecedented obesogenic environment. Large-scale quarantine and home confinement will impose new and unfamiliar stressors on children, thereby worsening the childhood obesity epidemic. Most importantly, adverse childhood events resulting from a predicted increase in domestic violence within the next few months will significantly contribute to this concern. The scenario presented in this review is of paramount public health importance and must be considered during future pandemic planning. Involved stakeholders, including governments, schools, and families, must make all possible efforts to minimize the impact of the COVID-19 epidemic on childhood obesity.

Background: Recurrent abdominal pain (RAP) is one of the frequent complaints in general practice, particularly in pediatrics and is among the common cause of referral to gastroenterology clinics. Purpose: This study is designed to investigate the effects of probiotics for the treatment of RAP and desired therapeutic outcomes. Methods: One hundred twenty-five children with the diagnosis of RAP according to Rome III criteria for irritable bowel syndrome (IBS), functional abdominal pain (FAP), functional dyspepsia (FD), and abdominal migraine (AM), were enrolled in this double-blind randomized controlled trial. Results: Sixty-five subjects received probiotics, and others received placebo treatment for 4 weeks. Lactobacillus reuteri was therapeutically effective in 32 patients compared to 8 patients, responding to the placebo treatment. Compared to baseline, all pain-related variables showed a significant reduction for the IBS and FD at the end of the 4th week. However, it did not respond well in FAP and AM groups. Pain-related outcomes such as, frequency of the pain, severity, and duration of the pain were decreased following the probiotic treatment. No therapeutic response was seen in AM group after the administration of probiotics. L. reuteri significantly led to pain relief in the overall population, and also in FAP, FD, and IBS subgroups. Conclusion: L. reuteri probiotics are likely to lead to RAP relief and can be recommended for the treatment of functional gastrointestinal disorders.

Background: Renal size is an important indicator in the diagnosis of renal diseases and urinary tract infections in children. Purpose: The purpose of this study is twofold. First, it aimed to measure the renal length and calculate the renal volume of normal Thai children using 2-dimensional ultrasonography (2D-US) and study their correlations with somatic parameters. Second, it aimed to compare the age-specific renal size of normal Thai children with the published data of their Western and Chinese counterparts. Methods: A total of 321 children (150 boys, 171 girls; age, 6-15 years) with a normal renal profile were prospectively recruited. All subjects underwent 2D-US by an experienced pediatric radiologist and the renal length, width, and depth were measured. Renal volume was calculated using the ellipsoid formula as recommended. The data were compared between the left and right kidneys, the sexes, and various somatic parameters. The age-specific renal lengths were compared using a nomogram derived from a Western cohort that is currently referred by many Thailand hospitals, while the renal volumes were compared with the published data of a Chinese cohort. Results: No statistically significant difference (P<0.05) was found between sexes or the right and left kidneys. The renal sizes had strong correlations with height, weight, body surface area, and age but not with body mass index. The renal length of the Thai children was moderately correlated (r=0.59) with that of the Western cohort, while the age-specific renal volume was significantly smaller (P<0.05) than that of the Chinese children. Conclusion: Therefore, we concluded that the age-specific renal length and volume obtained by 2D-US would vary between children in different regions and may not be suitably used as an international standard for diagnosis, although further studies may be needed to confirm our findings.