Authors’ conclusions: screening can detect adolescent idiopathic scoliosis (AIS). Bracing and possibly exercise treatment can interrupt or slow progression of curvature in adolescence. However, there is little or no evidence on long-term outcomes for AIS treated in adolescence, the association between curvature at skeletal maturity and adult health outcomes, the harms of AIS screening or treatment, or the effect of AIS screening on adult health outcomes.
Reviewers’ commentary: at the present time, there is not enough evidence to make a recommendation about the systematic and universal screening of adolescent idiopathic scoliosis.
Orejón de Luna G, Puebla Molina SF. Evid Pediatr. 2018;14:17
Authors’ conclusions: infants with bronchiolitis and hypoxemia, receiving high-flow oxygen therapy require less escalation of care than those who receive conventional oxygen therapy.
Reviewers’ commentary: this study is an open clinical trial with high risk of bias. Although there is uncertainty about the results, it seems that the use of high-flow oxygen therapy can reduce the rate of ICU admissions and lower levels of intensive respiratory care.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2018;14:18
Authors’ conclusions: in pediatric patients with clinical concern for acute appendicitis, the Point-of-Care Ultrasound (POCUS) is as accurate as radiology-performed ultrasound in evaluating children into a staged diagnostic algorithm, and it is more available, so it could be the first test to perform.
Reviewers’ commentary: a point-of-care ultrasound, performed by doctors not specialists in radiology, is a good option to increase the diagnostic efficacy for acute appendicitis in the child. But first and foremost, you must make sure that the doctor who performs it has a good reproducibility and concordance with radiologist sonographers, being essential for this purpose the adequate training to become competent and experienced in the performance of the examination.
Ortega Páez E, Martín Masot R. Evid Pediatr. 2018;14:19
Authors’ conclusions: among surviving extremely preterm infants, the rate of neurodevelopmental disability at 2 years did not differ significantly between infants who received early inhaled budesonide for the prevention of bronchopulmonary dysplasia and those who received placebo, but the mortality rate was higher among those who received budesonide.
Reviewers’ commentary: doubts persist about the benefit-risk relationship of early inhaled corticosteroid treatment in extremely premature infants who require assisted ventilation.
Author’s conclusions: the appropriate use of watchful waiting for the management of acute otitis media could simultaneously improve health outcomes and save costs for society. In contrast, the authors interpret that this attitude could imply an increase in visits, requiring additional education from parents and health personnel.
Reviewer’s commentary: this cost-effectiveness analysis demonstrates that watchful waiting management for acute otitis media in patients meeting criteria of the AAP guidelines, stratifying by age and severity symptoms, is associated with lower total costs and also avoids the loss of years of life due to disability. It would be necessary to conduct cost studies in Primary Care, adapted to our environment where it can be ensured a more exhaustive monitoring of patients and the costs could be even lower.
Authors’ conclusions: in children, vaccinated with 4CMenB between 12 and 24 months of age, there is a fall in protective antibodies at 4 years of age, which would justify a booster dose in cases with high risk.
Reviewers’ commentary: although, in an epidemic setting, the primary vaccination with two doses of 4cMenB in the second year of life is protective, the need of scheduling a booster dose in the vaccination calendar should be carefully evaluated.
Albi Rodríguez MS, Rodríguez-Salinas Pérez E. Evid Pediatr. 2018;14:22
Authors’ conclusions: providers are more likely to use antibiotics in non-RSV–infected patients compared with infected. These trends likely represent concern about bacterial superinfection and may reflect lack of familiarity with these pathogens.
Reviewers’ commentary: the use of antibiotics in viral respiratory infections is very high. This study does not allow the estimation of the impact of PCR rapid diagnostic tests. Although it is foreseeable that its availability would allow the optimization of antibiotic prescription, experimental studies are needed to evaluate its clinical, epidemiological and economic impact.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2018;14:23
Authors’ conclusions: available evidence does not support the use of corticosteroids for the prevention of esophageal strictures following caustic ingestion.
Reviewers’ commentary: current available data do not allow us to support the usefulness of corticosteroids for the prevention of esophageal stenosis after caustic ingestion.
Molina Arias M, Rodríguez-Salinas Pérez E. Evid Pediatr. 2018;14:24
Authors’ conclusions: the prevalence of sexting has increased in recent years and increases with youth age. Further research focusing on nonconsensual sexting is necessary to appropriately target and inform intervention, education, and policy efforts.
Reviewers’ commentary: in the case of sexts with consent, the prevalence rates for sending and for receiving are 14.8% and 27.4%, respectively. The corresponding rate for sending a sext without consent is 12%, and for having a sext forwarded without consent 8.4%. Sexting should be integrated into sex educational programs, and also adequate legal policies should be implemented to deal with the cases of nonconsensual sexting and their potential consequences.
Authors´ conclusions: there is no evidence of increased risk of subsequent asthma diagnosis among children younger than three years of age who received live-attenuated influenza vaccines compared with placebo.
Reviewers’ commentary: more studies are needed to assess the safety of live-attenuated influenza vaccines in children younger than two years of age.
Jullien S, Llerena Santa Cruz E. Evid Pediatr. 2018;14:26
Authors’ conclusions: IV magnesium sulfate is an effective treatment, with the pulmonary function significantly improved and hospitalization and further treatment decreased. But nebulized magnesium sulfate treatment showed no significant effect.
Reviewers’ commentary: IV magnesium sulfate, but not nebulized, seems to reduce the number of hospitalizations, and to improve respiratory function in severe asthmatic attacks, although optimal doses remain to be defined. It would be appropriate to propose studies with more homogeneous patients and more objective result measures.
Pérez-Moneo Agapito B, Rivero Martín MJ. Evid Pediatr. 2018;14:27
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