Abstract

Authors’ conclusions: in patients with familial hypercholesterolemia statin treatment started in childhood reduces the tendency to thicken of the carotid intima-media and the risk of cardiovascular disease in adulthood.

Reviewers’ commentary: statin treatment since childhood could be safe and decrease the chances of having an event or death from cardiovascular disease. The data obtained on the thickness of the carotid intima-media cannot be extrapolated, nor can a relationship be established between these data and the results found in the study.

Key words: hydroxymethylglutaryl-CoA reductase inhibitors; cardiovascular diseases; hyperlipoproteinemia type II; carotid intima-media thickness.

Abstract

Authors’ conclusions: high-dose methylprednisolone is effective in the treatment of severe M. pneumoniae pneumonia without increasing the incidence of adverse reactions.

Reviewers’ commentary: the methodological weaknesses of the clinical trials included in this review, their epidemiological scope, and the limited information on the characteristics of their patients make that the results of this review must be interpreted with caution. Although the use of corticosteroids in patients with poor evolution would be reasonable, a high quality multicentre clinical trial is necessary to verify the effect, before incorporating them into our clinical protocols.

Abstract

Authors’ conclusions: there is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment.

Reviewers’ commentary: transgender adolescents who receive hormonal treatment for pubertal suppression are at less risk for suicidal ideation than those who did not receive this treatment but wish they had received it.

Abstract

Authors’ conclusions: in children with acute bronchiolitis the use of lung ultrasound in the emergency department was a useful tool in predicting hospital admission, having a high correlation with clinical findings.

Reviewers’ commentary: point-of-care lung ultrasound could be a useful tool in predicting hospital admission in patients with acute bronchiolitis, but due to the limitations of the study, the present results must be interpreted with caution. It is necessary to know if it is useful in the Primary Care.

Abstract

Authors’ conclusions: treatment of patients affected by influenza-like illness in primary care with oseltamivir accelerates the recovery in an average of 1 day, being from 2 to 3 days in patients with older age, more severe symptoms, comorbidities and longer duration of previous symptoms.

Reviewers’ commentary: the intervention is applicable to the population attended in Primary Care in our setting. The size of the effect is moderate, even in risk subgroups, and its importance is more social and work-related than clinical. The quality of the evidence is moderate, although the level of recommendation will depend on the cost-effectiveness results.

Abstract

Authors’ conclusions: frequent use of household cleaning products in the home in early infancy is associated to an increased risk of wheezing and asthma in children, but not of atopy, at three years, showing a possible inflammatory effect in the respiratory tract, not an allergic acquired response.

Reviewers’ conclusions: the study results suggest that the use of cleaning products is associated with a higher incidence of recurrent wheezing and asthma in one in three children at the age of three years. But the medium level of quality of the study leaves the question open for further research, to try to clarify if common cleaning products could be preparing respiratory tract for future allergies.

Abstract

Authors’ conclusions: adults very low birth weight survivors showed a higher incidence of airflow obstruction, gas trapping, reduced gas exchange, and increased ventilatory inhomogeneity versus controls. The findings suggest pulmonary effects due to very low birth weight persist into adulthood, and bronchopulmonary dysplasia is a further insult on small airway function.

Reviewers’ commentary: this study suggests that it is important to perform lung function tests on very low birth weight adults and strongly discourage cigarette smoking at an early age.

Abstract

Authors’ conclusions: a point-of-care respiratory PCR panel improved patient care by providing an accurate diagnosis and shortened appointment duration.

Reviewers’ commentary: the indiscriminate performance of respiratory PCR panel in primary care seems to offer no advantages over its non-performance. The development of clinical criteria to choose the patients who would benefit from this measure in studies with better methodological design could be assessed.