Authors’ conclusions: diets with modified carbohydrate intake were as effective as portion-controlled diets in obese children. Adherence to low carbohydrate diet was lower.
Reviewers’ commentary: treatment of obese children with modified carbohydrate diets was as effective as treatment with portion controlled diet, but both of them were not clinically significant.These results are not generalizable because the study has important methodological limitations.
Carvajal Encina F, de Lucas García N. Evid Pediatr. 2013;9:61
Authors' conclusions: diagnostic accuracy of tests in children suspected of gastroesophageal reflux disease remains unclear and implications for practice are hard to give. There is an urgent need of well-designed randomized controlled trials where the effect of treatment according to specific signs and symptoms will be compared with the effect of treatment based on the results of additional diagnostic tests, for patient relevant outcomes.
Reviewers' commentary: existing studies not allow us to estimate the accuracy of diagnostic tests used in gastro-esophageal reflux disease. The degree of reflux identified by pH-metry seems not sensitive enough to differentiate clinically diagnosed cases. This suggests that the degree of reflux is only one of the parameters to evaluate, together with clinical information and other diagnostic tests, in the selection of patients who will benefit from treatment of the disease. Clinical trials that assess the utility of available tests in decision-making must be done.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2013;9:63
Authors' conclusions: bed sharing increases the risk of SIDS even if the parents do not smoke and in the absence of maternal consumption of alcohol or drugs. The presence of additional risk factors greatly increases this risk.
Reviewers' commentary: in the light of the results of this study, it seems reasonable to discourage bed-sharing practice with infants under three months of age and in any case, if there are additional risk factors.
Ortega Páez E, Molina Arias M. Evid Pediatr. 2013;9:64
Authors' conclusions: topical timolol maleate 0.5% gel is a safe an effective option for small superficial infantile hemangiomas that have not ulcerated and are not on mucosal surfaces.
Reviewers' commentary: topical timolol maleate may be useful for whitening and limited volume reduction of small superficial infantile hemangiomas with few side effects, but we don’t know whether this effect remains over time. These results should be confirmed by further studies, given the methodological limitations presented by this one.
Río-García MD, Aparicio Rodrigo M. Evid Pediatr. 2013;9:65
Authors’ conclusions: early limited formula may reduce longer-term formula use at one week and increase breastfeeding at three months for some infants. Early limited formula may be a successful temporary coping strategy for mothers to support breastfeeding newborns with early weight loss. Early limited formula has the potential for increasing rates of longer-term breastfeeding without supplementation based on findings from this RCT.
Reviewers’ commentary: to improve child nutrition, exclusive breastfeeding is recommended for the first six months of life. The methodological limitations of this study, do not allow to conclude that early feeding of infants with an extensively hydrolyzed formula could increase rates of exclusive breast feeding.
Authors’ conclusions: there is an increased risk of narcolepsy in children vaccinated with pandemic A/H1N1 2009 Pandemrix® in England.
Reviewers’ commentary: the available data suggest a special personal or population predisposition to some components of this vaccine. It seems adequate the interruption of commercialization of Pandemrix® by European Medicines Agency, although causality is not totally proved and the risk may have been overestimated.
Aparicio Rodrigo M, Esparza Olcina MJ. Evid Pediatr. 2013;9:67
Authors' conclusions: caregivers informed through video discharge instructions scores higher in questionnaires on child’s emergency visit compared with those informed through written instructions. Use of videos improves caregivers’ understanding of patient’s condition.
Reviewers' commentary: it’s possible for video discharge instructions to improve caregivers’ understanding on medical information although this study demonstrates a statistical difference instead a relevant clinical advantage. Other measures can offer the same results.
Ibáñez Pradas V, Martín Muñoz P. Evid Pediatr. 2013;9:68
Authors' conclusions: teenagers who received in childhood whole cell pertussis vaccine were more protected during the U.S. 2010-11 whooping cough outbreak than were those who received acellular vaccine.
Reviewers' commentary: the widespread use of acellular whooping cough vaccines has been related to the resurgence of disease outbreaks in recent years. Although causes are complex, the waning of vaccine-induced immunity appears to play an important role.
Authors' conclusions: specific HLA alleles (DRB1 and DQB1) are associated with antibody response to hepatitis B vaccination.
Reviewers' commentary: although the influence of HLA system in the immune response to the hepatitis B vaccine is something well established, the practice of the systematic HLA determination, prior to vaccination, to identify presumable responders to the vaccine is considered as something of little use in the daily practice, and it should be relegated to individuals with a special risk of suffering from hepatitis B.
Ortega Páez E, Molina Arias M. Evid Pediatr. 2013;9:70
Authors' conclusion: this study found that exposure to suicide predicts suicide ideation and attempts. These results support school-wide interventions over current targeted interventions, particularly over strategies that target interventions toward children closest to the decedent.
Reviewers' commentary: this study provides enough evidence that, among young people, exposure to suicide is a risk factor for suicidal behaviours in the future. Everyone who is exposed should be included in suicide prevention programs.
Juanes de Toledo B, Cuestas Montañés EJ. Evid Pediatr. 2013;9:71