Abstract

Authors’ conclusions: recent changes in cancer treatment are associated with improvement in survival of childhood cancer. The treatments have been modified with the goal of reducing late adverse effects of both chemo- and radiotherapy.

Reviewers’ commentary: there may be an association between a longer survival in childhood cancer and the recent changes in cancer treatments. The strategy of lowering therapeutic exposure to radiotherapy and chemotherapy seems to reduce long-term adverse consequences. However, the better medical care during the last years has not been well considered.

Abstract

Authors’ conclusions: the use of antidepressants, specifically selective serotonin reuptake inhibitors, during the second and/or third trimester of gestation increases the risk of autism spectrum disorder in children.

Reviewers’ commentary: antidepressants should be restricted during gestation and used only by those pregnant women properly diagnosed with mental disorders that do not improve sufficiently with only non-pharmacological therapies, like psychotherapy. For this reason, it is of vital importance to have made a correct diagnosis of the specific mental problem involved. As long as this situation remains, and the association continues as not fully clarified, we must strongly advise prudence and caution concerning the use of antidepressants during pregnancy.

Abstract

Authors’ conclusions: adding nebulized magnesium to nebulized bronchodilator and systemic corticosteroids therapy does not shorten the time to discharge of pediatric patients with moderate or severe asthma in the Emergency Department.

Reviewers’ commentary: nebulized magnesium added to usual therapy does not improve outcomes in children with moderate and severe asthma in the Emergency Departments. Future research should focus on the subgroup of selected severe cases, in which previous studies have shown some benefit.

Abstract

Authors’ conclusions: supplementation with 6400 IU / day for nursing mothers provides adequate levels of vitamin D in breastfed infants and represents an alternative to infant supplementation.

Reviewers’ commentary: exclusive maternal supplementation with high doses of vitamin D seems sufficient to maintain an optimal state of vitamin D, in both cases: for the mother and for her exclusively breastfed infant.”

Abstract

Authors’ conclusions: a protocol using a less invasive surfactant application did not increase survival without bronchopulmonary dysplasia, but was associated with increased survival without major complications. Because major complications are related to lifelong disabilities, LISA may be a promising therapy for extremely preterm infants.

Reviewers’ commentary: surfactant via a thin endotracheal catheter, during CPAP-assisted spontaneous breathing in extremely preterm infants with respiratory distress syndrome is feasible, has no significant side effects and does not increase costs, achieving, besides that, a decrease in those cost associated with mechanical ventilation.

Abstract

Authors’ conclusions: melatonin supplementation is a safe and effective way to improve the sleep-onset latency and disease severity in children with atopic dermatitis.

Reviewers’ commentary: melatonin supplementation could be a promising alternative to relieve sleep problems associated with atopic dermatitis in children.

Abstract

Authors’ conclusions: selective ECG use for preparticipation athletic evaluations has a high rate of identification of cardiac disease. Adoption of a mass ECG screening program would need to prove to be more efficient at identifying diseases associated with sudden cardiac death than a selective approach.

Reviewers’ commentary: due to the methodological shortcomings of this study, the results don’t make any change to current guidelines regarding preparticipation athletic evaluations among youths. Current European and Spanish guidelines advise using ECG screening in preparticipation athletic evaluations.

Abstract

Authors’ conclusions: risk of death is not increased in the period of 0-30 days post-vaccination. No deaths causally associated with vaccination were found.

Reviewers’ commentary: there appears to be no causal relationship between vaccination and death within 30 days post-vaccination.

Abstract

Authors’ conclusions: there is an increased risk of some haematologic cancer in children born by assisted reproductive techniques but not in overall cancer.

Reviewers’ commentary: the small increased risk of leukemia and Hodgkin lymphoma, as well as the notable difference in the age tracking cohorts, reduces the study’s quality of evidence. More studies are needed before attributing carcinogenic effect to assisted reproductive techniques.

Abstract

Authors’ conclusions: palivizumab prophylaxis was associated with reduced wheezing episodes and hospitalizations during the first two years of life in children born extremely prematurely. However, it did not affect pulmonary outcome at school age.

Reviewers’ commentary: the results of this study, because of the design (observational with historical control), small and unrepresentative sample, discordant short- and long-term results, do not support long-term effect of palivizumab on respiratory symptoms or lung function. Estimates of short-term effect are very imprecise.

.

Abstract

Authors’ conclusions: adjunctive laser acupuncture significantly reduced the duration of morphine therapy in newborns with neonatal abstinence syndrome (NAS).

Reviewers´ commentary: in NAS non pharmacological care is the initial treatment option, and pharmacological treatment is required if an improvement is not observed after no pharmacological measures. Adjunctive laser acupuncture could reduce the duration of morphine therapy in newborns with NAS. However, the sample size is too small to generalize the results of the study