Authors´conclusions: on the basis of immunogenicity responses this study provides evidence for an adolescent aga 4CMenB vaccine schedule of two doses, 1-6 months apart, to provide portection against meningococcal B infection. The extent of this protection against meningococcus B variants circulating worldwide will be determined by national surveys.
Reviewers´commentary: the results of this study support the utility of this new vaccine as local reactogenictity until one month . Recommendations and implementation strategies will depend on knowledge of the predominant strains.
Llerena Santa Cruz E, Buñuel Álvarez JC. Evid Pediatr. 2012;8:73
Authors' conclusion: parents rated the honey products higher than the silan placebo syrup for symptomatic relief of their children’s nocturnal cough and sleep difficulty sleeping due to upper respiratory tract infection (URI). Honey may be a preferable treatment for nocturnal cough and sleep difficulty associated with childhood URI.
Reviewers' commentary: honey seems to relieve cough compared to placebo associated with URI and although there is insufficient evidence for or against, as to show where children over one year, given the limited side effects presents (cariogenic effect ), could be an alternative for these patients.
Ortega Páez E, Cuestas Montañés EJ. Evid Pediatr. 2012;8:74
Authors’ conclusions: carrying backpacks increases the risk of back pain and possibly the risk of back pathology. The prevalence of school children carrying heavy backpacks is extremely high. Preventive and educational activities should be implemented in this age group.
Reviewers’ commentary: in this study nearly 5 in 20 children reported back pain lasting more than 15 days in the previous year, compared with 6 in 20 children of those carrying the heaviest backpacks. Although this study has a cross-sectional design and it can not establish a causal relationship, limiting the weight in the backpacks up to 10 to 15% of the body weight seems sensible.
Authors' conclusions: treatment with inhaled glucocorticoids reduces growth amongst prepuberal children in the first two years, what is associated with a lower adult height.
Reviewers' commentary: inhaled glucocorticoids have shown efficacy in reducing asthma symptoms. The possible effects on adult height do not seem to be important enough to waive their benefits but it is useful to remind that its use is not completely free of adverse events and that they should be avoided in patients with sporadic symptoms in whom the risks probably outweight the benefits.
Gimeno Díaz de Atauri Á, Rivas Juesas C. Evid Pediatr. 2012;8:76
Authors' conclusions: esomeprazole treatment does not reduce the discontinuation rate owing to symptoms worsening in children with gastroesophageal reflux disease. Improved diagnostic criteria may help to identify reflux patients who may benefit from this treatment.
Reviewers' commentary: esomeprazole treatment does not influence the clinical outcome of infants with gastroesophageal reflux. These results are expected due to the inclusion criteria used in the study, but they probably would be different if treatment were limited only to children with proven peptic disease and gastrointestinal symptoms.
Molina Arias M, Ortega Páez E. Evid Pediatr. 2012;8:78
Authors' conclusions: human metapneumovirus and respiratory syncyitial virus severity risk factors may differ slightly. These findings will inform metapneumovirus prevention strategies.
Reviewers' commentary: it remains unclear the utility of defininig risk factors for human metapneumovirus severe infections. New studies with larger sample size are needed to concrete those risk factors.
Gimeno Díaz de Atauri Á, Rivas Juesas C. Evid Pediatr. 2012;8:79
Authors' conclusions: the current evidence is not of sufficient quality to inform the public about the benefits and harms of sports products.
Reviewers' commentary: it has been widely disseminated that it is advisable to use special products such as drinks and supplements to improve sports performance and avoid dehydration. However, the available studies do not support these statements.
Authors' conclusions: adrenocorticotropic hormone (ACTH) is more effective than vigabatrin (VGB) for the treatment of infantile spasms, low-dose ACTH is probably as effective as high-dose ACTH, data are insufficient to establish or discard the equivalence of other corticoids and ACTH and for making recommendations about other treatments. In the long term, hormonal therapy obtains better outcomes in respect to psychomotor development.
Reviewers' commentary: this is a systematic review with an acceptable quality level. Although the available evidence about the treatment of infantile spasms is in general of low or medium quality, until better studies become available, it seems reasonable to accept that the treatment of choice for infantile spasms, not related to tuberous sclerosis, is low-dose ACTH.
Authors' conclusions: only 12% of infants presenting to the emergency department with apparent–life threatening events had a significant intervention warranting hospital admission. The use of a new clinical decision rule would have decreased the admission rate safely by 40%.
Reviewers' commentary: the clinical decision rule designed in this study selects three groups of patients with episodes of apparent life threatening with low risk of needing hospital care and procedures. It is possible that most of these patients do not require hospitalization, although, in the absence of an external validation of this rule, only an individual interpretation of all circumstances guarantees the best option for each patient.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2012;8:82