Authors’ conclusions: childhood overweight at 7 years of age was associated with increased risk of adult type 2 diabetes only if it continued until puberty or later ages.
Reviewers’ commentary: although the prevalence of overweight in our setting is much higher than that observed in this study, the increased relative risk found seems consistent and would be applicable to our male child population. The final period of childhood could be a window of opportunity to reduce the risks associated with overweight and obesity. The fight against obesity should start at school age.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2018;14:32
Authors conclusions: the implementation of the Neonatal Sepsis Calculator was feasible and safe in our unit. Application of this clinical decision support tool may reduce the number of infants undergoing investigations and empirical treatment for suspected Early Onset Sepsis
Reviewer’s commentary: suspicion of early onset neonatal sepsis is a frequent cause of hospitalization, use of diagnostic tests and empirical indication of antibiotics. Despite some methodological limitations of the research, the use of the Neonatal Sepsis Calculator would reduce these effects, in tertiary hospitals, to ensure adequate pre and post-discharge follow-up.
Authors’ conclusions: ibuprofen and morphine are both effective reducing postoperative pain after minor outpatient orthopedic surgery. There are not significant differences in effectiveness, but there are more adverse effects with morphine. Ibuprofen is a safer option as first line analgesic.
Reviewers’ commentary: there is no evidence that oral morphine is superior to ibuprofen for the treatment of mild postoperative pain, but there is evidence that it produces more adverse effects. Nevertheless, these findings could be not applicable to situations of moderate to severe pain.
Martínez Rubio M.V, Esparza Olcina MJ. Evid Pediatr. 2018;14:34
Authors’ conclusions: neither the content of sodium chloride nor the infusion rate of intravenous fluid therapy influenced the appearance of early or late neurological adverse effects in children with diabetic ketoacidosis.
Reviewers’ commentary: in children with diabetic ketoacidosis and with a Glasgow Coma Scale (GCS) score of >11, the replacement time of the volume deficit can be shortened and 0.45% saline can be used, without producing neurological damage. It would be convenient to carry out new studies that help us to better define the subgroups that would benefit from each type of replacement.
de Lucas García N, Flores Villar S. Evid Pediatr. 2018;14:35
Authors’ conclusions: there was no association between fasting duration and any type of adverse event, indicating that delaying sedation to meet established fasting guidelines does not improve sedation outcomes for children in the emergency department.
Reviewers’ commentary: it seems wise to follow strictly the protocols in risky cases such as serious illness, hyperemesis, bowel obstruction, endoscopy or bronchoscopy, but in other situations this practice does not show evidence of benefit, so an appropriate review of protocols on pre-sedation fasting is advisable.
Esparza Olcina MJ, Jullien S. Evid Pediatr. 2018;14:36
Authors’ conclusions: according to the findings of the study, GIP fecal measurement in celiac disease could help to detect recent gluten-free transgressions without the need for additional tests. Therefore, it would be convenient to introduce GIP in the assessment of compliance with GFD to improve the adherence of the patients.
Reviewers’ commentary: the traditional methods used for the monitoring and adherence of the gluten free diet in the celiac population do not seem to reflect correctly if it is produced. The measurement of fecal GIP could be useful during follow-up, mainly to ensure good compliance and to rule out refractory celiac disease in selected patients, being able to avoid more bloody tests or problems derived from poor adherence to the diet.
Martín Masot R, Ortega Páez E. Evid Pediatr. 2018;14:37
Authors’ conclusions: a small increased risk of poorer motor development may exist for children who are exposed to antidepressants during pregnancy. The marked methodological variation among studies and the limited control for possible confounds warrants cautious interpretation of these findings.
Reviewers’ commentary: the methodological limitations of the study do not allow us to establish solid recommendations based on their conclusions. However, it could be useful to monitor the motor development in infants and children exposed to clarify the doubts that exist about this point.
Carvajal Encina F, Pérez-Moneo Agapito B. Evid Pediatr. 2018;14:38
Authors’ conclusions: exposure to household disinfectants was associated with higher BMI at age 3, mediated by gut microbial composition at age 3-4 months. Although child overweight was less common in households that cleaned with eco-friendly products, the lack of mediation by infant gut microbiota suggests another pathway for this association.
Reviewers’ commentary: probably may be a relationship between household disinfectants and child overweight through changes in the composition of the gut microbiota. It remains to be determined if there is a cause-effect relationship, or there is some common confusion between both situations.
Juanes de Toledo B, Cuestas Montañés E. Evid Pediatr. 2018;14:42