Authors’ conclusions: hospital admissions due to bronchiolitis in children under one year of age are associated with a higher risk of hospitalizations due to respiratory diseases in preschool age, although there is not enough data to establish a causal relationship. It should be assessed, in well-designed clinical trials, if preventive measures that demonstrate efficacy in reducing admissions from bronchiolitis also have an impact on subsequent admissions due to respiratory causes.
Reviewers’ commentary: the results are in line with previous ones and it shows the great burden that a first hospital admission for bronchiolitis entails in the first year of life. It also highlights the importance of future preventive actions to reduce this impact, even though it is not relevant to usual clinical practice of bronchiolitis management.
De Manuel Gómez C, Gimeno Díaz de Atauri Á. Evid Pediatr. 2019;15:44
Authors’ conclusions: infant proton pump inhibitors alone or together with H2 receptor antagonists is associated with an increased childhood fracture risk. This risk appears amplified by duration or early initiation of the therapy.
Reviewers’ commentary: the increased risk of fractures associated with antisecretory treatment during the first year of life another argument to carefully assess the indication of these drugs, especially proton pump inhibitors, particularly in treatments at an early age or long-term treatments.
Molina Arias M, Pérez-Moneo Agapito B. Evid Pediatr. 2019;15:45
Authors’ conclusions: in this study, genetic factors are less important than environmental factors in the appearance of caries. Water fluoridation, maternal obesity and hypomineralized first temporary molars can be important caries risk factors on which we can take proper action in order to reduce the prevalence of tooth decay.
Reviewers’ commentary: in the development of early dental caries at six years of age, the environmental risk factors (modifiable) are more important than the genetic ones (deterministic). Intervening early on those modifiable factors we can reduce the risk of childhood caries.
Cuervo Valdés JJ, Ortega Páez E. Evid Pediatr. 2019;15:46
Authors’ conclusions: the immune response to the booster dose was similar regardless of whether the primary vaccination schedule consisted of 2 or 3 doses. A Meningococcus B (Trumemba®) booster dose 4 years after receiving the primary vaccination, appears safe, well tolerated and leads to a strong immune response that indicates immunological memory.
Reviewers’ commentary: after a booster dose 4 years after the primary vaccination with a bivalent vaccine against Meningococcus B (Trumemba®), it is possible to reactivate the immune response in adolescents against the tested strains of this bacterium, regardless of whether the primary vaccination was done with 2 or 3 doses. The immune response has only been assessed a month after reinforcement.
Rivero Martín MJ, García Vera C. Evid Pediatr. 2019;15:47
Authors’ conclusions: routine immunization at 12-13 years with three doses of bivalent HPV vaccine is associated to an important reduction in cervical disease 7 years later, measured with cytology and histology. Reduction in non-vaccinated women was also observed, probably due to herd protection.
Reviewers’ commentary: in practice, the efficacy achieved with bivalent HPV routine vaccination in populations with good vaccine coverage, is high. The results obtained from this study could lead to consider future modifications in population-based cancer screening among groups with optimum coverage.
Albi Rodríguez MS, Esparza Olcina MJ. Evid Pediatr. 2019;15:48
Authors’ conclusions: the overall mortality rate in pediatric acute respiratory distress syndrome (ARDS) is approximately 24%. Among the studies included in the review, a consistent trend towards improvement in survival was demonstrated for those published later, comparing with those previous in time.
Reviewers’ commentary: the mortality estimated in this study is applicable to our clinical practice, except for hospitals with few cases and patients treated with surfactant. It is therefore a reference to consider when assessing the quality of care in our intensive care units. However, it does not provide risk estimates, based on the severity of the patients.
Ochoa Sangrador C, Flores Villar S. Evid Pediatr. 2019;15:49
Authors’ conclusions: e-AT use led to high and sustained participation in self-monitoring and improved asthma outcomes. Dissemination of this care model has potential to broadly improve pediatric ambulatory asthma care.
Reviewers’ commentary: the study proposes the use of a computer program to support asthma self-control for children, which seems to improve outcomes, but with significant difficulties in its follow-up.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2019;15:50
Authors’ conclusions: the continuous perfusion of vancomycin succeeds in improving the results of the current standard procedure of intermittent administration, in terms of achievements of target concentrations, with the addition of also requiring lower total daily doses to reach the desired concentration, and without being able to find associated adverse effects.
Reviewers’ commentary: although the results seem very encouraging, this work contains limitations that, for the time being, would not allow us to guarantee that continuous infusion of vancomycin is a safe alternative, nor to affirm that it is cost-effective.