Authors' conclusions: in otherwise healthy late preterm infants, palivizumab treatment resulted in a significant reduction in wheezing days during the first year of life, even after the end of treatment. These findings implicate RSV infection as an important mechanism of recurrent wheeze during the first year of life in such infants.
Reviewers' commentary: we should know the clinical consequences of the avoided wheezing episodes before estimating the applicability of the results of this study in our clinical practice. This is because the cost of the proposed treatment is high and of course much higher than the treatment of these episodes (6.4 doses should be put to prevent one episode of wheezing). Finally, we also need to know whether prevention showed in the first year of life will last over time.
Ochoa Sangrador C, González de Dios J. Evid Pediatr. 2013;9:42
Authors' conclusions: as no validated predictive score exist and pending the contribution of the S-100B protein assay, the identificatión of infants at high risk for traumatic brain injuries (TBI) and justifying neuroimagining is based on the search for predisposing factors and circunstances.
Reviewers' commentary: risk factors significance advised to suspect more brain lesions were emergency referral by a physician, age less than three months and dropped from a height greater than 90 cm.
Cuestas Montañés EJ, Ortega Páez E. Evid Pediatr. 2013;9:43
Authors' conclusions: this systematic review did not find any evidence that NIDCAP improves long-term neurodevelopmental or short-term medical outcomes.
Reviewers' commentary: although NIDCAP (Newborn Individualized Developmental Care and Assessment Program) did not show consistent and maintained clinical improvements in the premature infant, its qualitative value in humanization and family centered care is undeniable. This systematic review does not take into account all that the NIDCAP entails, but is does pose some interesting questions. Should the NIDCAP be applied as a form of standard premature care or are other developmental focused methods enough?. And most importantly is the cost of NIDCAP trainings justifiable?. It is not the moment to lose faith in the NIDCAP but it is the moment to reflect on it. It is also an opportune moment to propose two types of study to apply to the NIDCAP: qualitative and economic evaluation.
González de Dios J, Buñuel Álvarez JC. Evid Pediatr. 2013;9:44
Authors’ conclusions: the implementation of the English smoke-free legislation appears to be associated with a decrease in the rate of hospital admission for childhood asthma.
Reviewers' commentary: this study supports the association between the reduction in asthma admissions and reduced exposure to passive smoking. The broadcastof these effects may promote avoidance of passive smoking in children and adolescents.
Fernández Rodríguez MM, Orejón de Luna G. Evid Pediatr. 2013;9:45
Authors' conclusions: intussusception is more common in children with CD than in the general pediatric population. This cause should be suspected even in apparently healthy children, specially if nutritional abnormalities or failure to thrive are detected in the context of abdominal symptoms.
Reviewers' commentary: to confirm the results of this study it would be necessary the implementation of well-designed prospective studies with control variables that an entry modifier the relationship between intussusception and celiac disease and also to know if the results are reproductible in other studies. These data are not sufficient to change, for the moment, the management of intussusception.
Authors' conclusions: maternal use of valproate during pregnancy was associated with a significantly increased risk of autism spectrum disorder and childhood autism in the offspring, even after adjusting for confounding factors (maternal epilepsy included).
Reviewers' commentary: the use of valproate during pregnancy should be approached with an appropriate balance between the benefits (seizure control) versus disadvantages (embryopathy and, with these results, increased risk of autism spectrum disorder). Given these findings, it seems appropriate to propose the replacement of valproate during pregnancy by other antiepileptic drug.
González Muñoz M, González de Dios J. Evid Pediatr. 2013;9:47
Author's conclusions: reference values for Korean children and adolescents and shows that, in a nationally representative population, alanine aminotransferase levels greater than the upper normal limit predict the existence of cardiovascular risk factors.
Reviewers' commentary: it is necessary to accurately determine the relationship between alanine aminotransferase levels and metabolic syndrome in our population before we can safely recommend it as a surrogate marker of cardiovascular risk.
Molina Arias M, Ortega Páez E. Evid Pediatr. 2013;9:48
Authors' conclusion: pandemic influenza virus infection in pregnancy was associated to an increased risk of fetal death. Vaccination Turing pregnancy reduced the risk of an influenza diagnosis. Vaccination its elf was not associated to increased fetal mortality and may have reduced the risk of influenza-related fetal death during the pandemic.
Reviewers' commentary: the vaccine against H1N1 influenza virus is safe during the second and third trimester of pregnancy. This study has the largest sample to date to evaluate this vaccine. The risk of fetal death during pregnancy was not statistically significant.
Llerena Santa Cruz E, Guarch Ibáñez B, Murga Cabero S. Evid Pediatr. 2013;9:49
Authors' conclusions: low risk parous women in primary care at the onset of labour with planned home birth had lower rates of severe acute maternal morbidity, than those with planned hospital births, although in both cases morbidity is low.
Reviewers' commentary: in the context of a well-organized health system, with well-trained midwives and an effective transport system, in selected cases, homebirths may result in less maternal morbidity than hospital ones. However, this study does not address the safety of the neonate, which in other studies in less-controlled contexts, has shown an increase in morbidity and mortality.
Balaguer Santamaría A, González de Dios J. Evid Pediatr. 2013;9:50
Authors' conclusions: there's an increased risk of asthma within the first five years of life in high risk children whose mothers received antibiotics in the third trimester of gestation. These findings are supported by a national cohort with unselected children.
Reviewers' commentary: the rational use of antibiotics during pregnancy in mothers with history of asthma could decrease the incidence of asthma in their children. Nevertheless, more studies are needed to confirm this association and the real impact in child's health.
Rivas Juesas C, García Vera C. Evid Pediatr. 2013;9:51