Authors’ conclusions: high birth weight and high early-life UV exposure may be important independent risk factors for melanoma diagnosis before age 30.
Reviewers’ comments: this case-control epidemiological study with high sample size and an appropriate design states that having a high birth weight and greater UV exposure at an early age are independent factors related to a higher incidence of melanoma before 30 years old. However, the presence of uncontrolled factors and possible selection bias could alter these results. More studies are needed to confirm this relationship.
Ortega Páez E, Llerena Santa Cruz E. Evid Pediatr. 2019;15:1
Authors’ conclusions: Among preschool children with acute gastroenteritis, those who received a 5-day course of Lactobacillus rhamnosus GG did not have better outcomes than those who received placebo.
Reviewers’ commentary: This trial does not support the recommendation to administer Lactobacillus rhamnosus GG as an effective treatment to prevent moderate to severe acute gastroenteritis.
Juanes de Toledo B, Martín Masot R. Evid Pediatr. 2019;15:2
Author’s conclusions: beneficial effects of the combined pre- and post-natal intervention with the probiotic Lactobacillus rhamnosus HN001, regarding the protection against eczema, are maintained for at least the first decade of life, with possible extension to the atopic march.
Reviewers’ commentary: the results are not good enough to systematically recommend supplementation with probiotics for the prevention of the atopic march. The initial effect achieved is very limited and does not seem to be maintained in the long term.
Molina Arias M, Rivero Martín MJ. Evid Pediatr. 2019;15:3
Authors’ conclusions: azithromycin provides another therapeutic option in patients with bronchiectasis and mild exacerbation, allergic to penicillin or with poor compliance with medical orders; although it should be considered that it leads to longer duration of symptoms, as well as greater risk of therapeutic failure and of inducing resistance to macrolides, with respect to amoxicillin-clavulanate acid.
Reviewers’ commentary: azithromycin may be a second-choice alternative for the treatment of children with bronchiectasis and mild or moderate exacerbations, in the absence of other severity factors such as cystic fibrosis or Pseudomonas aeruginosa infection.
Molina Arias M, Rivas Fernández MÁ. Evid Pediatr. 2019;15:4
Authors’ conclusions: young people with an alcohol-specific admission are at increased risk of subsequent injury requiring hospitalization, especially immediately post discharge, indicating a need for prompt intervention as soon as alcohol misuse behaviors are identified.
Reviewers’ commentary: this cohort study demonstrates the increased risk of injuries related to alcohol abuse in the population of the United Kingdom. Being the first month after discharge for alcohol abuse the period in which the highest risk is identified, an early intervention and a strict control of these adolescents should be carried out.
Aizpurua Galdeano P, Llerena Santa Cruz E. Evid Pediatr. 2019;15:5
Authors’ conclusions: the introduction of fish early in life (6-9 months) and regular consumption of all fish (at least once a week) reduces asthma and wheeze in children up to 4.5 years old, while fatty fish intake may be beneficial in older children. Future well-designed clinical trials are recommended to confirm the promising findings.
Reviewers’ commentary: the design of the studies analyzed and their heterogeneity do not allow conclusions to be drawn on the possible protective effect of fish intake on childhood asthma, although some studies point to this. At the moment there is not enough evidence to make a firm recommendation on fish intake in asthmatic children, although it should be recommended to every child as part of a healthy diet.
Aparicio Rodrigo M, Martínez Rubio M.V. Evid Pediatr. 2019;15:6
Authors’ conclusions: antibiotic prophylaxis is not indicated for the prevention of renal scarring after a first or second symptomatic or febrile urinary tract infection in otherwise healthy children.
Reviewers’ commentary: incidence of renal scarring after febrile urinary tract infection in healthy children is low, around 6%. There are not differences between prophylaxis and control groups, so prophylactic antibiotic therapy is not justified.
Miranda Mallea J, González Rodríguez P. Evid Pediatr. 2019;15:7
Authors’ conclusions: prophylaxis with high doses of Vitamin D (1200 IU / day) is adequate to prevent the flu epidemic, as demonstrated by the rapid reduction of symptoms, greater reduction of viral load and early recovery. In addition, its administration is probably safe in children.
Reviewers’ commentary: vitamin D is effective and safe in the prevention of influenza at a dose of 1200 units per day, but these data are unreliable, due to the methodological deficiencies of the study analyzed.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2019;15:8
Authors’ conclusions: room air has a 27% relative reduction in short-term mortality compared with FiO2 1.0 for initiating neonatal resuscitation ≥35 weeks' gestation.
Reviewers’ commentary: this study indicates that there is a significant reduction in the relative risk of short-term mortality in the group that received room air. It would seem reasonable to start resuscitation in term or near-term newborns with room air if the preductal saturation of O2 is tightly controlled to individually adjust the FiO2 to patient's response.
Cuestas Montañés EJ, Aizpurua Galdeano P. Evid Pediatr. 2019;15:9
Authors’s conclusions: the results of this meta-analysis indicate that echinocandins show non-inferior efficacy compared with amphotericin B formulations, with better compliance than in the control group, when used for the treatment of invasive candidiasis in children.
Reviewer’s commentary: the available experimental evidence on the comparative efficacy of echinocandins with respect to amphotericin B is of low quality because of imprecision. They do not seem to be less effective and, although the clinical trials have not shown less adverse events, the better lower rate of treatment withdrawal suggests that they have advantages of tolerance.
Andrés de Llano JM, Ochoa Sangrador C. Evid Pediatr. 2019;15:10
Conclusions of the authors of the study: enterovirus PCR should be part of the clinical practice guidelines for children 2 years old and younger. This test could reduce the length of hospital stay and reduce exposure to antibiotics for low-risk patients admitted from the emergency room with febrile illness.
Reviewers' commentary: detection of enteroviruses in blood can lead to reduced admissions and to a reduction in the use of antibiotic therapy in newborns and infants who come to the emergency room with fever without source and / or with sepsis-like disease, during the seasonal periods of high prevalence of the virus. There may be a marginal benefit in children with meningitis symptoms.
Flores Villar S, Pérez-Moneo Agapito B. Evid Pediatr. 2019;15:11
Authors’ conclusions: hospital-based postnatal education increased parental use of pain interventions at infant vaccinations and can be added to existing education.
Reviewers’ commentary: with the data of this study we can conclude that a specific brochure and/or video intervention can contribute to increasing the use of analgesic techniques in vaccination.
Ruiz-Canela Cáceres J, Fraile Astorga G. Evid Pediatr. 2019;15:12
Critically appraised articles
