Authors´ conclusions: nirsevimab prevents hospitalization and severe hospitalization due to respiratory syncytial virus in lower respiratory tract infection.
Reviewers´ commentary: nirsevimab appears effective and safe, at least in the short term. There are doubts about the clinical importance of the magnitude of the effect, so alternatives to the current universal immunization strategy should be considered, such as evaluating exclusive immunization of children under three months of age or the combination of the vaccine in pregnant women with immunization in high-risk infants.
Authors´ conclusions: among newborns undergoing arterial switch for transposition of great arteries (TGA), prenatal diagnosis is associated with poorer early postoperative outcomes. In addition to minimizing iatrogenic factors (such as planned births) resulting in earlier births, evaluation of other dynamics following a prenatal diagnosis which may result in poor fetal growth and earlier onset of spontaneous labor is important.
Reviewers´ commentary: prenatal diagnosis of TGA is associated with a higher prevalence of earlier births (both induced and spontaneous), as well as smaller-for-gestational-age neonates, both factors having a negative effect on early postoperative morbidity of these patients. It would be necessary to study the impact that prenatal diagnosis can have on maternal stress and its relationship with small fetuses for gestational age. In our clinical practice, a critical measure applicable would be to allow the spontaneous delivery of these fetuses unless it is not recommended due to individual circumstances. The results of this study may not be applicable to populations in low-income countries or those with lower prenatal screening rates.
Authors´ conclusions: in children with primary snoring and mild sleep apnea hypopnea syndrome, early adenotonsillectomy does not improve executive function or attention at 12 months, although it could improve other related symptoms.
Reviewers´ commentary: the study has some methodological issues and does not find data that support the proposed intervention in terms of the main outcomes. More studies are needed to identify patients with sleep-disordered breathing who would benefit from surgery in the long term.
Authors´ conclusions: the findings of this cohort study suggest that among toddlers diagnosed with ASD, baseline adaptive function and sex may be associated with persistence of ASD.
Reviewers´ commentary: the results of this study show that more than a third of children who received a clinical diagnosis of ASD between the ages of 1 and 3 years no longer met the criteria for ASD on a subsequent evaluation, although the diagnostic methodology used was different, validated only in research. Importantly, ASD-specific intervention was not predictive of non-persistent ASD at 6 years. Together with the published literature, these data raise important considerations regarding early diagnosis and treatment of the disorder. Early diagnosis and intervention of ASD increases parental stress and pressure on young children.
Balado Insunza MN, Aizpurua Galdeano P. Evid Pediatr. 2024;20:33
Authors´ conclusions: a single dose of Butantan-DV prevented symptomatic DENV-1 and DENV-2, regardless of dengue serostatus at baseline, through 2 years of follow-up.
Reviewers´ commentary: in this study, Butantan-DV has been shown to be effective and safe in the prevention of symptomatic dengue against DENV-1 and DENV-2, even in children 2 years of age or older, regardless of the initial serological status. It looks like a promising vaccine for a disease that is currently a major public health problem in many countries and a threat to others where climatic suitability for dengue is increasing.
Author’s conclusions: the current predictive scales for liver fibrosis lack diagnostic precision, therefore new non-invasive diagnostic tools are needed to stage fibrosis.
Reviewers’ commentary: currently available noninvasive scales for detecting the presence of liver fibrosis in non-alcoholic fatty liver disease do not have sufficient diagnostic accuracy and precision, showing no advantage over liver biopsy. Better non-invasive tools are needed for the classification and staging of patients with liver non-alcoholic fatty liver disease.
Cabrera Morente L, Ortega Páez E. Evid Pediatr. 2024;20:35
Authors´ conclusions: the MMBV test was more accurate than the medical assessment in determining the etiology of the infection, also demonstrating high sensitivity and specificity.
Reviewers´ commentary: the MMBV test can be useful to discriminate bacterial from viral infections in pediatric emergency wards but needs further evaluation if decisions to use it.
Perdikidis Olivieri L, Martín Masot R. Evid Pediatr. 2024;20:36
Authors´ conclusions: this meta-analysis reinforces the association between elevated eosinophil blood count (EBC) and the risk of future asthma. EBC is a cost-effective and easily accessible tool for assessing future asthma risk in preschool children with wheezing and, as such, can aid physicians in making informed therapeutic decisions. A large, focused, prospective, multi-center cohort study is required to set a reliable cutoff point or predictive model for EBCs as predictors of asthma in the preschool population.
Reviewers´ commentary: there are data on the association between the level of EBC in preschool children with wheeze and the development of asthma, but we still need more information to establish the optimal cut-off point that will allow us to select those children at high risk, to be able to take specific measures. The key will be the development of predictive models able to weigh all the factors involved in the development of asthma, with optimal studies and the application of new methods capable of handling such broad and complex information.
Albi Rodríguez MS, Fraile Astorga G. Evid Pediatr. 2024;20:37
Editorial
