Authors' conclusions: Tdap vaccination of pregnant women from 20 weeks of gestation is the best strategy for preventing morbidity and mortality from pertussis in young infants
Reviewers' commentary: in case of whooping cough epidemic, Tdap vaccination of pregnant women from 20 weeks of gestation can be considered due to the high rates of mortality and hospitalization among young infants. However, it is necessary that the public health authorities decide the policies to adopt. We think that any experience must be monitored to evaluate mid-and long-term results.
Ruiz-Canela Cáceres J, Aizpurua Galdeano P. Evid Pediatr. 2013;9:3
Authors' conclusions: clinicians are able to diagnose pneumonia in children and young adults using point-of-care ultrasonography, with high specificity.
Reviewers' commentary: the predictive value of ultrasonography is much better than the exploratory signs. It could be enough to diagnose pneumonia. However, before considering its implementation in clinical practice, it is necessary to study its reproducibility and feasibility.
Andrés de Llano JM, Ochoa Sangrador C. Evid Pediatr. 2013;9:4
Authors’ conclusions: there is no evidence of developmental delay in children, between 1 and 5 years of age, with severe neonatal hyperbylirubinemia with no symptoms or minor symptoms of acute bilirubin neonatal encephalopathy.
Reviewers’ commentary: it seems that severe neonatal hyperbilirubinemia in newborns of gestational age above 35 weeks, does not affect psychomotor development in the first five years of life. This is consistent with the results of previous studies.
Aparicio Rodrigo M, Aparicio Sánchez JL. Evid Pediatr. 2013;9:5
Authors' conclusions: national policies for the vaccination of healthy children are based on very little reliable evidence. Influenza vaccines are efficacious in preventing cases of influenza in children older than two years of age, but little evidence is available for children younger than that. Further randomized clinical trials are needed to prove the efficacy and safety of influenza vaccines, especially regarding inactivated virus vaccines and children under two years of age.
Reviewers' conclusions: overall review of literature shows that universal influenza vaccination may have a favourable cost-benefit ratio. Nevertheless, there is scarce evidence about vaccine efficacy in children less than two years of age. So, given the difficulties to implement systematic influenza vaccination in Spain, at this time, it seems reasonable to maintain current recommendations, awaiting new efficacy and safety studies and the development of more effective vaccines.
Molina Arias M, González de Dios J. Evid Pediatr. 2013;9:6
Authors’ conclusions: the studies evaluated in this systematic review do not support the claim that the private sector is usually more efficient, accountable, or medically effective than the public sector; however, the public sector appears frequently to lack timeliness and hospitality towards patients.
Reviewers’ commentary: this systematic review concludes that there is no evidence that private healthcare systems are better than the public healthcare sector in low and middle income countries, except for punctuality and hospitality. Moreover, the private health sector shows lower adherence to clinical guidelines and a higher expenditure in treatments. To be able to address the efficiency of these health systems, the cost associated to this lack of adequacy should be taken into account.
Authors' conclusions: in subjects with irritable bowel syndrome who have their symptoms controlled after gluten-free diet, the gluten challenge is a trigger digestive symptoms and fatigue, without evidence of inflammation or intestinal damage.
Reviewers' commentary: irritable bowel syndrome is a very heterogeneous clinical entity whose diagnosis most often is by exclusion. To know the exact implication of gluten, it would take well-designed clinical trials with adequate sample size and strict diagnostic inclusion criteria to determine which group of patients with functional gastrointestinal symptoms could benefit from the exclusion of gluten from the diet.
Molina Arias M, Ortega Páez E. Evid Pediatr. 2013;9:8
Authors' conclusion: this study suggests a causal relationship between non-sexual child abuse and a range of mental disorders, suicidal attemps, sexually transmitted infections, and risky sexual behaviour. All forms of child maltreatment should be considered important risks to health, contributing to increase the burden of disease in all parts of the world. Measures should be taken to identify the child population at risk as well as promote interventions to protect children from violence.
Reviewers' commentary: this study provides some causality evidence between nonsexual abuse and neglect in childhood and long-term increased risk of mental illness, drug abuse, suicide and sexual risk behavior, this facts require to have a highly responsible attitude for early abuse and neglect cases detection to treat them and prevent the presence of long-term sequelae.
Cuestas Montañés EJ, Juanes de Toledo B. Evid Pediatr. 2013;9:9
Authors' conclusions: inhaled corticosteroids (ICS) therapy reduces hospital admissions in patients with acute asthma who are not treated with oral or intravenous corticosteroids. They may also reduce admissions when they are used in addition to systemic corticosteroids; however, the most recent evidence is conflicting. There is insufficient evidence that ICS therapy can be used in place of systemic corticosteroid therapy when treating acute asthma.
Reviewers' commentary: inhaled corticosteroids added to the standard treatment of asthma attacks (systemic corticosteroids) can reduce admissions Further studies are needed for clarify doses, devices, drugs and the possibility of long time adverse effects.
Gimeno Díaz de Atauri Á, Rivas Juesas C. Evid Pediatr. 2013;9:11
Authors' conclusions: children gained little additional sleep on melatonin; although they fell asleep significantly faster, waking time become earlier. Child behaviour and family functioning outcomes did not significantly improve.
Reviewers' commentary: there is a weak recommendation in favor of making a trial of melatonin for three months in children with neurodevelopmental disorders and severe sleep disturbances, with monitoring of response.
González de Dios J, González Muñoz M. Evid Pediatr. 2013;9:12
Authors' conclusions: the cost of immunoprophylaxis with palivizumab far exceed the economic benefit of preventing bronchiolitis hospitalizations, even in infants at highest risk for respiratoy syncytial virus infection.
Reviewers' commentary: the information provided by this study may help health managers to consider the indications of this therapy, taking fully into account the circumstances of any given community.
González de Dios J, Balaguer Santamaría A. Evid Pediatr. 2013;9:13