Authors´ conclusions: oropharyngeal colostrum application significantly reduces the incidence of culture-positive sepsis and mortality in preterm neonates.
Reviewers´ commentary: oropharyngeal colostrum application in premature infants is associated with a statistically significant reduction in the incidence of confirmed sepsis. However, doubts persist regarding its clinical impact in extremely premature newborns.
Carvajal Encina F, Oltra Benavent M. Evid Pediatr. 2024;20:42
Authors’ conclusions: the new Phoenix sepsis criteria, which were derived from validated data from higher- and lower-resource settings, show improved performance in diagnosing and prognosing sepsis and septic shock in pediatrics compared to those other criteria from the 2005 International Pediatric Sepsis Consensus Conference (IPSCC), existing to date.
Reviewers´ commentary: the IPSCC (International Pediatric Sepsis Consensus Conference) criteria, used since 2005, had shown low specificity and did not allow risk stratification. If they were applied in hospitals with different degrees of complexity, they could become discordant with the clinical diagnosis. With the new Phoenix criteria, it is possible to centralize all clinical data from any location with greater sensitivity and specificity, when diagnosing and predicting sepsis and septic shock in pediatrics.
Balado Insunza MN, Flores Villar S. Evid Pediatr. 2024;20:43
Authors ́ conclusions: there is an association between antibiotic use and the development of Kawasaki disease over the next 12 months.
Reviewers ́ commentary: the use of antibiotics is associated with a slight higher risk of Kawasaki disease. The population studied, with a high incidence of disease and high exposure to antibiotics, could question the external validity and its applicability to other population groups. These findings reinforce the need for further research to identify the previously unknown underlying mechanisms of Kawasaki disease.
Blanco Rodríguez C, Ochoa Sangrador C. Evid Pediatr. 2024;20:44
Authors' conclusions: transanal irrigation is successful in 62% of children with functional constipation. It is the first meta-analysis that focuses on children with functional constipation, but a greater number of prospective clinical trials are needed to evaluate this treatment option in functional constipation.
Reviewers' comments: the methodological limitations of this meta-analysis prevent conclusions from being drawn that would allow recommendations to be made for the use of transanal irrigation in functional constipation in children.
Molina Arias M, Cabrera Morente L. Evid Pediatr. 2024;20:45
Authors’ conclusions: the migratory status of the parents increases some perinatal risks. These risks are different depending on the migratory category of the progenitors (family, economic or refugee).
Reviewers’ commentary: the adverse perinatal effects in newborns from the immigrant population are greater compared to the native population and are worse in the refugee group. These differences must be taken into account to provide adequate health and social services in these families.
Esparza Olcina MJ, Blanco Rodríguez C. Evid Pediatr. 2024;20:46
Authors´ conclusions: dupilumab resulted in pathological remission in a significantly higher percentage of children with eosinophilic esophagitis than placebo.
Reviewers´ commentary: dupilumab is an effective treatment in paediatric patients with eosinophilic esophagitis. Due to its cost and limited experience of use, it should initially be reserved for patients who have been refractory to the rest of the available treatments.
Pérez Solís D, Pérez-Moneo Agapito B. Evid Pediatr. 2024;20:47
Authors´ conclusions: in studies in which all infant hips were screened for developmental dysplasia of the hip, the prevalence of a dislocated hip was 0.94%. A positive likelihood ratio for the Barlow and Ortolani maneuvers was the finding most associated with an increased likelihood of a dislocated hip. Limited hip abduction or a clicking sound had no clear diagnostic utility.
Reviewers´ commentary: the Ortolani and Barlow clinical maneuvers for screening for developmental dysplasia of the hips present good specificity with respect to ultrasound diagnosis, although their low sensitivity, especially if performed by non-experts, does not allow avoiding potential cases of late diagnosis.
Oltra Benavent M, Cuestas Montañés EJ. Evid Pediatr. 2024;20:48
Author’s conclusions: antibiotic and acid suppressant exposition, during prenatal period and first infancy, increase the risk of eosinophilic esophagitis.
Reviewer’s commentary: the aforementioned exposures may increase the risk of pediatric eosinophilic esophagitis. However, some of them must be valued prudently due to biases found in the article. Further studies are required.
Gámez Belmonde A, Ortega Páez E. Evid Pediatr. 2024;20:49
Authors´ conclusions: there is moderate-certainty evidence that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries. The remaining evidence is low to very-low certainty and is insufficient for determining which, if any, other intervention types and features may be effective, and in which settings.
Reviewers´ commentary: advice on diet and infant feeding practices to pregnant women, mothers or other caregivers with children up to the age of one year may slightly reduce the risk of developing caries in deciduous teeth. It therefore seems reasonable to include it in routine check-ups for pregnant women and infants, along with the recommendation of the use of age-appropriate fluoride toothpastes, whose beneficial effects are firmly established. However, this review highlights the lack of evidence on interventions to prevent this childhood disease, which is preventable and highly prevalent, especially in children from disadvantaged families and low-income countries.
Authors´ conclusions: for childhood soft tissue sarcoma, pre-diagnostic symptoms differ by age and location, highlighting the need to tailor early diagnosis interventions.
Reviewers´ commentary: this paper gathers data from a large number of heterogeneous articles that can be applicable to our environment. It lists the most frequent symptoms by age and location of soft tissue sarcomas in children with the aim of achieving an early diagnosis, which leads to improved survival.
Authors’ conclusions: acetaminophen use during pregnancy was not associated with children's risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding.
Reviewers' commentary: this population-based cohort study adjusts for confounding factors including the use of other drugs during pregnancy, their indications and the influence on unexposed siblings. The results do not question the safety of acetaminophen use during pregnancy in relation to these neurodevelopmental alterations. The possibility of using this analgesic may be of benefit to pregnant women who need to treat pain or fever during pregnancy.
Fernández Rodríguez MM, Aparicio Sánchez JL. Evid Pediatr. 2024;20:52
Editorial
