Authors’ conclusions: there is a social gradient in the mental health of children and young adolescents in Spain. No social gradient was found for health related quality of life (HRQoL), although children from families of disadvantaged social classes had slightly worse HRQoL scores than their counterparts from more advantaged classes.
Reviewers’ commentary: in Spanish children and young adolescents’ social statusand educational level of the mother influenced mental health and in a lesser extent, the health related quality of life. Health systems should act to protect the health of children of disadvantaged families.
González Rodríguez MP, Velarde Mayol C. Evid Pediatr. 2013;9:24
Authors’ conclusions: the results indicate that delayed initiation of antimicrobial treatment does not worsen the recovery from acute otitis media, as measured by improvement during treatment. However, watchful wating before the initiation of delayed antimicrobial treatment might be associated with transient wrsenning of a child´s condition, porlongation of symptoms and economic losses.
Reviewers’ commentary: this study does not provide conclusive information regarding the decision to treat or not acute otitis media in children between 6 months and 3 years old. Further studies are needed to establish which of these patients may benefit from delayed treatment.
Llerena Santa Cruz E, Ruiz-Canela Cáceres J. Evid Pediatr. 2013;9:25
Authors' conclusion: topiramate and trazodone have limited evidence supporting efficacy for episodic migraines.
Reviewers' commentary: trazodone and topiramate reduced the rate of monthly headache episodes; however, quality of the evidence was deemed moderate to low and the result might not be considered clinically significant, mainly because this reduction is equivalent to one less headache episode per month. None of these medications reduced at least 50% the frequency of headaches.
Cuello García CA, Pérez Gaxiola G. Evid Pediatr. 2013;9:26
Authors' conclusions: there is an observer bias in randomized clinical trials with results of subjective measurement scale. Lack of blinding in evaluating the results in these trials increases a quarter of the standard deviation of the measuring scale used.
Reviewers' commentary: unblinded assessment of subjective effect measures seems to cause an overestimation of the effect in epidemiological studies. However, the magnitude of the estimated error in the studies of this review can not be generalized. Any study that uses subjective scale measures should consider employing masking techniques or at least try to control or quantify the potential mistake.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2013;9:27
Authors' conclusions: routine vaccination with 13-valent pneumococcal vaccine decreases the incidence of invasive pneumococcal disease.
Reviewers' commentary: vaccination with the PCV13 appears more effective than PCV7, although it would be interesting to study the cost-effectiveness of the vaccine and the possible increase of other serotypes causing infection.
Río-García MD, Molina Arias M. Evid Pediatr. 2013;9:28
Authors’ conclusions: among free diet people, the intake of free sugars or sugar sweetened beverages is a determinant of body weight. The change in body fatness that occurs with modifying intake seems to be mediated via changes in energy intake, since isoenergetic exchange of sugars with other carbohydrates was not associated with weight change.
Reviewers’ conclusions: the intake of sugar sweetened food or beverages has been linked to obesity. This systematic review shows that sugar intake in adults is related to weight gain and sugar reduction to weight reduction. In children, an association between the intake of sugar sweetened beverages and obesity has been proven. This review supports the recommendation of reducing the intake of sugar sweetened foods and beverages.
Authors' conclusions: the NICE traffic light system for predicting severe infections in children with fever did not identify a significant proportion of these especially UTIs. The association with a urinalysis increased its utility.
Reviewers' commentary: the addition of leukocyte esterase and urinary nitrites to the NICE rule for predicting severe infections, increases its utility in 2.65% more severe infections detected. Taking into account the ease of the procedure and its low cost make it especially useful in Primary Care.
Ortega Páez E, Perdikidis Olivieri L. Evid Pediatr. 2013;9:30
Authors' conclusions: age-specific assessment is important in the evaluation of acute asthma or reactive airway exacerbation. Diastolic hypotension may serve as an early warning indicator of severity of disease and need for hospitalization. The variability of vital signs as a predictor of hospitalization in different age groups, requires the development or refinement of assessment tools age-related acute asthma.
Reviewers' commentary: the ability to accurately predict the need for hospitalization by measuring objective parameters obtained in triage, would optimize care and improve patient outcomes. However, this study presents under review presents many methodological problems that limit their internal validity and generalizability of their results.
Carvajal Encina F, de Lucas García N. Evid Pediatr. 2013;9:31
Authors' conclusions: the results suggest a relationship between the consumption of fast food and asthma, rhinoconjunctivitis and atopic eczema. The regular intake of fruit and vegetables seem to protect against these diseases. If the association is causal it could be relevant for public health.
Reviewers' commentary: stating that fast food worsens the symptoms of asthma and other atopic diseases is too much to say only with these results. More studies are required in which nutritional data and other factors that may influence the development of these pathologies are taken into account all together.
Gimeno Díaz de Atauri Á, Rivas Juesas C. Evid Pediatr. 2013;9:33