Authors’ conclusions: in full-term new-borns from developed countries, applying antiseptics to the umbilical cord versus just keeping it clean and dry, was not superior to prevent omphalitis, in addition to being costly higher. Therefore, this practice can be replaced by keeping the cord clean and dry.
Reviewers’ commentary: for new-borns without risk factors in developed countries, keeping the umbilical cord clean and dry is a good procedure to prevent omphalitis in the new-born. More studies would be needed to assess its efficacy in situations of clinical or epidemiological risk, as well as in the case of developing countries.
Martín Masot R, Orejón de Luna G. Evid Pediatr. 2017;13:16
Authors’ conclusions: this study highlights the lack of robust evidence comparing Non-operative treatment for acute uncomplicated appendicitis with appendicectomy but provides data that support and justify ongoing and future endeavours.
Reviewers’ commentary: there is still insufficient evidence to consider non-operative treatment of acute appendicitis in routine practice.
Cuestas Montañés E, Aparicio Rodrigo M. Evid Pediatr. 2017;13:17
Authors' conclusions: infants following a modified version of baby-led weaning (thebaby-ledintroductiontosolids[BLISS]) did not choke more often than infants following traditional feeding practices, However, high proportions of infants in both groups were offered foods posing a choking risk.
Reviewers' commentary: although in the study there are a number of pre-randomization losses that may compromise external validity, the analysis of the results seems to support this technique of feeding the infant. Studies with a greater number of participants, diverse socioeconomic extracts and better advice on foods likely to cause choking should be analyzed.
Díaz Cirujano AI, Molina Arias M. Evid Pediatr. 2017;13:19
Authors' conclusions: supplementation with n−3 long chain polyunsaturated fatty acids in the third trimester of pregnancy reduced the absolute risk of persistent wheeze or asthma and infections of the lower respiratory tract in offspring by approximately 7 percentage points, or one third.
Reviewers' commentary: although the results of this clinical trial indicate a preventive relationship between omega-3 fatty acid supplementation and asthma development, detected limitations (cointerventions and differences in other asthma-related risk factors) and discrepancies with other studies, do not support supplementation of pregnant women for this purpose.
Fernández Rodríguez M, Aizpurua Galdeano P. Evid Pediatr. 2017;13:20
Authors’ conclusions: public-access defibrillation was associated with an increased chance of neurologically favorable survival in pediatric out-of-hospital cardiac arrest (aged 1–17 years) who received bystander cardiopulmonary resuscitation, except for in cases of unwitnessed or non-cardiac etiology.
Reviewers’ commentary: there is a clear association between the use of publicly available defibrillators and improved outcomes in cases of pediatric cardiorespiratory arrest. Despite the limitations of the investigation to establish relations of causality, being it an observational study, a comprehensive control of possible confounding variables was performed.
Gimeno Díaz de Atauri Á, Rodríguez-Salinas Pérez E. Evid Pediatr. 2017;13:21
Authors’ conclusions: bedtime use of a media device was significantly associated with inadequate sleep quantity, poor sleep quality, and excessive daytime sleepiness. An integrated approach among teachers, health care professionals, and parents is required to minimize device access at bedtime.
Reviewers’ commentary: it seems that the use of portable screen media devices at least one hour before sleep time can induce qualitative and quantitative disturbances in child's sleep and daytime sleepiness. Although the quality of the evidence is low, the importance of sleep in childhood and the probability of its disturbance by electronic devices make it advisable to minimize their use at least 1 hour before bed time and their presence at the child´s room.
Aparicio Rodrigo M, Buñuel Álvarez JC. Evid Pediatr. 2017;13:22
Authors’ conclusions: growing evidence supports a preventive role of vitamin D during pregnancy on offspring wheeze and/or respiratory tract infections.
Reviewers’ commentary: further studies are required to confirm the efficacy and safety of high-dose vitamin D supplementation in pregnancy, since the available evidence is imprecise and there are doubts about its applicability in clinical practice.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2017;13:23
Authors’ conclusions: the diagnosis of neonatal abstinence syndrome is strongly associated with poor school performance.
Reviewers’ commentary: even with the differences between the Australian and Spanish educational systems, the results of the study would probably be applicable to our environment, since they could reflect the isolated effect of neonatal abstinence syndrome on school failure. This would justify that these children in their school stage would be especially identified and screened for low school performance for their inclusion in a support program whose cost-benefit should be evaluated in prospective studies.
Ortega Páez E, Molina Arias M. Evid Pediatr. 2017;13:24
Authors’ conclusions: in agreement with what is known for adult patients, the use of absorbable sutures containing the antiseptic triclosan in children, compared to conventional ones, effectively reduces the incidence of surgical wound infections.
Reviewers’ commentary: even in populations with a low prevalence of surgical wound infections, the use of absorbable sutures containing triclosan versus conventional sutures reduces the presence of this complication by about half. More safety and cost-effectiveness studies in childhood are needed to recommend its use widely.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2017;13:25
Authors’ conclusions: lung ultrasound plays a significant role in the detection of community-acquired pneumonia, not inferior to chest x-ray and without radiation exposure.
Reviewers’ commentary: in children with a high degree of clinical suspicion of pneumonia, pulmonary ultrasonography, performed by expert personnel, is of comparable utility to radiography. However, before proceeding to its generalized use, should be assessed its role, when it is performed by less experienced staff.