Authors' conclusions: Viscous xylitol solution in a dose of 5 g 3 times per day was ineffective in reducing clinically diagnosed AOM among otitis-prone children.
Reviewers' commentary: This is a study, of acceptable quality and methodological design that found no differences between placebo and xylitol with respect to the number of episodes of acute otitis media. However, the preparation and administration were quite different from other studies, which found a prophylactic effect in healthy children without recurrent otitis.
García Vera C, Llerena Santa Cruz E. Evid Pediatr. 2014;10:41
Authors' conclusions:Lactobacillus reuterii reduces pulmonary exacerbations and episodes of otitis in patients with cystic fibrosis with mild-to-moderate lung disease.
Reviewers' commentary: although Lactobacillus reuterii seems to reduce respiratory exacerbations in patients with cystic fibrosis, it remains to be determined how long the effect last, wich the most adequate strain is, and what its effectiveness on lung function over time is.
Molina Arias M, Ortega Páez E. Evid Pediatr. 2014;10:42
Authors’ conclusions: bracing significantly decreased the progression of high-risk curves to the threshold for surgery in patients with adolescent idiopathic scoliosis. The benefit increased with longer hours of brace wear.
Reviewers’ commentary: this randomized clinical trial is the first one on bracing in adolescent idiopathic scoliosis published so far. It produces evidence on the prevention of surgery in some selected cases of scoliosis.
Esparza Olcina MJ, González de Dios J. Evid Pediatr. 2014;10:44
Authors' conclusions: a model for early severe intraventricular hemorrhage prediction was developed and tested in our population of very low birth weight infants. Prophylactic indomethacin was associated with a lower risk-adjusted incidence of severe intraventricular hemorrhage.
Reviewers' commentary: this study presents a simple five-variable model that, although with only moderate accuracy, can improve the selection of those very low birth weight preterms at high risk of developing severe ventricular hemorrhage. The association found between indomethacin prophylaxis and lower risk of major bleeding should be confirmed with studies designed to confirm the causal relationship and to evaluate the long-term neurologic outcomes of the treated children.
Rivas Fernández MÁ, Aizpurua Galdeano P. Evid Pediatr. 2014;10:45
Authors' conclusions: the 13-Valent Pneumococcal Conjugate Vaccine reduced colonization by the six new additional vaccine serotypes among children. Unvaccinated adults also experienced comparable reductions indicating substantial indirect protection from vaccine.
Reviewers' commentary: the 13-Valent Pneumococcal Conjugate Vaccine appears effective in reducing nasopharyngeal colonization by vaccine serotypes, although long-term studies should be done to confirm these results and their effect in decreasing rates of invasive pneumococcal disease.
Martínez Rubio M.V, Juanes de Toledo B. Evid Pediatr. 2014;10:46
Authors' conclusions: antimicrobial prophylaxis in children with vesicoureteral reflux is associated with a reduced risk of urinary tract infections recurrence, but not of renal scarring.
Reviewers' commentary: this study describes a reduction of recurrent urinary tract infection after antibacterial prophylaxis with trimethoprim-sulfamethoxazole in children under six years with vesicoureteral reflux, regardless of its degree. Given the lack of effect on renal scarring, and having in mind the methodological shortcoming of the study, its findings cannot support any change in current recommendations.
Ortega Páez E, Aparicio Rodrigo M. Evid Pediatr. 2014;10:47
Authors' conclusions: motavizumab has no effect on viral load, nor improves the clinical course of patients admitted with lower respiratory tract infection caused by respiratory syncytial virus.
Reviewers' commentary: motavizumab does not improve the clinical course of infants with lower respiratory tract infection caused by respiratory syncytial virus. Interestingly, the treated cases have a tendency to have worse clinical outcomes, which is significant for the risk of admission to intensive care and mechanical ventilation.
Ochoa Sangrador C, González de Dios J. Evid Pediatr. 2014;10:48
Authors' conclusions: the use of helmet therapy is not routinely recommended for healthy infants with moderate skull deformation, based on the equal effectiveness with its natural course and the high prevalence of adverse effects and high costs.
Reviewers' commentary: despite the fact of its small sample size, the results of the study indicate the lack of improvement with the orthotic helmet, what is an expensive and uncomfortable treatment. In healthy infants it seems better to recommend conservative posture.
Rivas Juesas C, González de Dios J. Evid Pediatr. 2014;10:49
Authors' conclusions: in extremely low birth weight infants, risk for mortality and necrotizing enterocolitis is increased, and retinopathy of prematurity decreased with a low oxygen saturation target.
Reviewers' commentary: this study offers first class evidence about risk and benefits associated with different ranges of oxygen saturation in low birth weight infants. Although methodological flaws are negligible, concern is raised as oxygen saturation targets used for patients allocation don't fit with clinical practice.
Carvajal Encina F, Ibáñez Pradas V. Evid Pediatr. 2014;10:50