Authors´ conclusions: nightly use of 0.05% atropine eyedrops among children aged 4 to 9 years without myopia resulted in a significantly lower incidence of myopia and lower percentage of participants with fast myopic shift at 2 years.
Reviewers´ commentary: this study, of adequate design and quality, concludes that atropine in low concentration helps prevent the onset and rapid progression of myopia in high-risk children, with few side effects. Long-term follow-up is pending to assess adequate follow-up time and possible rebound effect after suspension.
Pérez González E, Martínez Rubio M.V. Evid Pediatr. 2024;20:16
Authors´ conclusions: the use of omalizumab is a cost-effective option for most children with uncontrolled severe pediatric allergic asthma, especially those who have frequent exacerbations; the costs are progressively reduced in successive years of treatment.
Reviewers´ commentary: according to the results of this study, the use of omalizumab in the treatment of severe asthma, despite its cost, appears to be efficient, being more cost-effective in the prevention of exacerbations than in the continuous control of the disease. These results are specifically applicable to our hospital setting.
Ortega Páez E, González Rodríguez MP. Evid Pediatr. 2024;20:17
Authors´ conclusions: maternal Group B Streptococcus (GBS) vaccine elicited anti-capsular polysaccharide antibodies against group B streptococcus in pregnant women that were transferred to infants, at levels associated with a reduced risk of invasive group B streptococcal disease.
Reviewers´ commentary: hexavalent vaccine against invasive disease due to group B streptococcus in pregnant women seems safe, although studies are needed to establish the optimal composition and doses, and its effectiveness in the newborn.
Authors´ conclusions: childhood cancer survivors have an excess risk of late mortality even 40 years after diagnosis, due to the leading causes of death in the general population. A Better lifestyle and the absence of cardiovascular risk factors are associated with reductions in this risk and should be the focus of attention in the future.
Reviewers´ commentary: is a large, well-designed retrospective study of childhood cancer survivors, with a large patient sample and long follow-up, 40 years or more. An excess of long-term mortality is confirmed, and protective factors related to lifestyle and the absence of diabetes and high blood pressure are detected.
Martínez Rubio M.V, Perdikidis Olivieri L. Evid Pediatr. 2024;20:19
Authors´ conclusions: patients with inflammatory bowel disease are at increased risk of developing cancers associated with thiopurine treatment, such as lymphoma and melanoma, as well as non-melanoma skin cancer. On the other hand, cancers associated with the disease itself, such as colorectal cancer, small intestine cancer and cholangiocarcinoma, do not seem to be associated with greater disease activity, and there could even be an inverse association with the number of relapses.
Reviewers´ commentary: the increased risk of cancer associated with the use of thiopurines is important enough to be taken into account when choosing maintenance treatment. The lower risk of cancer associated with therapeutic escalation should be confirmed in future studies.
Ochoa Sangrador C, Ortega Páez E. Evid Pediatr. 2024;20:20
Authors conclusions’: depression in children is rare and its prevalence is stable until 2019. There is a lack of data to be able to measure it during the years of the pandemic.
Reviewers` commentary: from a resource management point of view, it is essential to determine the prevalence of depressive disorders during childhood, so that resources can be used effectively and directed to patients who need them most urgently. This review reveals that there is no evidence of an increase in depressive disorders in children under 13 years of age, adjusting to pre-pandemic data. The results of this study will be relevant to compare them in the future with studies carried out in the years of the pandemic and post-pandemic.
Balado Insunza MN, Esparza Olcina MJ. Evid Pediatr. 2024;20:21
Authors’ conclusions: delayed umbilical cord clamping in premature infants reduces mortality before hospital discharge.
Reviewers' commentary: the study provides high-quality evidence that delayed umbilical cord clamping, compared with immediate umbilical cord clamping, reduces death before discharge in premature infants. This conclusion will have great application in clinical practice and will probably lead to the modification of international recommendations for the initial management of premature newborns.
Authors´ conclusions: children born moderately preterm (32-33 weeks) are at a higher risk of screening positive for or being diagnosed with developmental disorders compared to term born children. This association is also demonstrated in late preterm and early term born children, but effect sizes are smaller.
Reviewers´ commentary: this systematic review with meta-analysis indicates that infants born between 32 and 38 weeks of gestation have an increased risk of cerebral palsy and other neurodevelopmental disorders. However, the present methodological limitations indicate the need for these findings to be confirmed by other studies.
Cabrera Morente L, Esparza Olcina MJ. Evid Pediatr. 2024;20:23
Authors´ conclusions: exposure in the womb to certain anti-seizure medications was associated with an increased risk of certain major congenital malformations which, in many cases, is dose dependent. Levetiracetam and lamotrigine appear to be the anti-seizure medications associated with the lowest level of risk, but more data are needed, particularly concerning individual types of malformation and higher doses. For many of the antiseizure medications considered in this review, there were too little data to reach conclusions.
Reviewers´ commentary: this review provides guidance on the most appropriate antiepileptic drug for patients with epilepsy who decide to become pregnant, so that they could try to change to less teratogenic drugs (the most advisable are Lamotrigine or Levetiracetam) prior to pregnancy and try to reduce the dose of dose-dependent antiepileptic drugs (valproate, phenobarbital, carbamazepine or lamotrigine).
Cabrera Morente L, Aparicio Rodrigo M. Evid Pediatr. 2024;20:24
Authors´ conclusions: the use of probiotics appears to have no effect on anthropometric data in malnourished children.
Reviewers´ commentary: treatment with probiotics does not seem to have a benefit on nutritional status in malnourished children under 5 years of age in developing countries.
Molina Arias M, Rodríguez-Salinas Pérez E. Evid Pediatr. 2024;20:25
Editorial
