Authors’ conclusions: vaccination against rotavirus could have a significant impact on the decline in hospital admissions related to seizures, especially in younger children.
Reviewers’ commentary: should the decline in hospital admissions for convulsive episodes, after widespread vaccination against rotavirus, be confirmed, might then this be an additional benefit of the vaccine, that could become a reason for its inclusion in vaccinationand immunization programs, but we need studies more powerful to confirm the effect.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2015;11:39
Author’s conclusions: use of isotonic intravenous fluid with a sodium concentration of 140 mmol/l had a lower risk of hiponatremia, without an increase in adverse effects, than did fluid containing 77 mmol/l of sodium. An isotonic fluid should be used as intravenous fluid for maintenance hydration in children.
Reviewers’ commentary: isotonic solutions are safer than hypotonic solutions in hospitalized children requiring IV fluids therapy in terms of avoiding hiponatremia.
Modesto i Alapont V, Cuestas Montañés EJ. Evid Pediatr. 2015;11:40
Authors’ conclusions: low levels of hand hygiene were observed. It is necessary to undertake future efforts to improve hand hygiene in the children´s hospitals included in this study.
Reviewers’ commentary: this study found low levels of hand hygiene, similar to other published studies. It is necessary to find measures to implement this practice in both, health workers and parents of pediatric patients, and in both cases the same for patients in hospital that for outpatients, to reduce the interpersonal transmission of infectious diseases.
Aparicio Rodrigo M, Río-García MD. Evid Pediatr. 2015;11:41
Authors´ conclusions: the limited published evidence on benefits and harms of routine iron supplementation, and of screening to prevent iron deficiency anaemia in young children in developed countries, indicates no benefits in growth and neurodevelopmental test scores, and variability on hematologic outcomes.
Reviewers´ commentary: the available evidence, scarce and of average quality, about prophylactic iron in healthy children 6-24 months old, shows no benefits in growth or neurodevelopmental scores, nor in hematological parameters.
Albi Rodríguez MS, Aparicio Rodrigo M. Evid Pediatr. 2015;11:42
Authors´ conclusions: the risk of developing herpes zoster is higher among those exposed to the disease than among the vaccinated. Before systematic vaccination, the incidence is higher and onset earlier when infection takes place between one and two years of age. During vaccination period, those with chickenpox with two or more years of age, have an increased risk of herpes zoster.
Reviewers´ commentary: although the study does not analyze costs, prevention of disease without increasing the incidence of herpes zoster would be in favor of routine vaccination against varicella in childhood. The impact after a longer period of monitoring implementation of universal vaccination should be analyzed.
Díaz Cirujano AI, Molina Arias M. Evid Pediatr. 2015;11:43
Authors´ conclusions: MMR vaccination was associated with reduced rate of hospital contacts related to laboratory-confirmed RSV infection. Further research on the association between MMR vaccination and other unrelated pathogens are warranted.
Reviewers´ commentary: the results of this study show a non-specific protective effect of the MMR vaccine, with a decrease in the incidence of respiratory syncytal virus (RSV) infection in children, to a greater extent when more time passed from the day of vaccination. Although this is a cohort study, with the risk of bias, it meets the quality criteria required for this type of study. When informing parents about vaccines, we could tell them that the MMR vaccine could decrease the risk of serious RSV infection, an illness with high incidence in early life.
Buñuel Álvarez JC, Francisco González L. Evid Pediatr. 2015;11:44
Authors’ conclusions: both scoring systems can be of assistance in setting the diagnosis of acute appendicitis, but none has adequate predictive values. The final decision remains on the clinical experience.
Reviewers’ commentary: the scores assess the possibility of an inflammatory disease in the abdominal right lower quadrant. The definitive diagnosis is less relevant than the early surgical indication.
Juanes de Toledo B, Martínez Rubio M.V. Evid Pediatr. 2015;11:45
Authors´ conclusions: presepsin (P-SEP) is an accurate biomarker for the diagnosis of late-onset sepsis in preterm newborns and may also provide useful information for monitoring the response to therapeutic interventions.
Reviewers´ commentary: accuracy of P-SEP as new biomarker for late-onset sepsis in premature will be marked by two events: the availability of the test in the hospital and the cost-effectiveness study versus C-reactive protein and procalcitonin.
Rodríguez-Salinas Pérez E, González de Dios J. Evid Pediatr. 2015;11:46
Authors' conclusions: breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.
Reviewers' commentary: prolonged breastfeeding is associated with a higher intelligence quotient at 30 years of age. This association persists after controlling the effect of educational level and family income and produces more education and income level in adulthood. Although the estimate of the effect comes from an observational study, it could have a significant impact at population level, justifying the investment in breastfeeding promotion.
Andrés de Llano JM, Ochoa Sangrador C. Evid Pediatr. 2015;11:47
Authors' conclusions: azithromycin decreases interleukin-8 nasopharyngeal concentration during the study period, and delayed the onset of a subsequent third episode of recurrent wheezing during the monitoring period.
Reviewers' commentary: the results of this trial are not sufficient to recommend indiscriminate use of azithromycin for the treatment of acute bronchiolitis during admission, nor to prevent possible further episodes of recurrent wheezing. If azithromycin actually had any clinically important effect on acute bronchiolitis and its recurrences, it should be demonstrated in a clinical trial specifically designed for this purpose, since the results of a pilot trial cannot be taken as a basis for changes in everyday clinical practice.