Authors´ conclusions: the findings of the study show that at three months of age, most children did not have protective titers of antibody against measles. These findings have important implications for general immunization and post-exposure recommendations, since until now, it was considered that up to six months of age there was immunity for measles. Additional studies are needed to prospectively validate these data and to explore the impact on that of maternal age and breastfeeding.
Reviewers´ commentary: according to the data of the study, immunity against measles in infants, acquired from their mothers, decreases significantly after three months and is practically non-existent at six months of age. These data could justify the advancement in the administration of the first dose of the MMR vaccine before one year of age, but before that it would be necessary to carry out immunity and tolerance studies and determine the ideal age for it.
Flores Villar S, Ortega Páez E. Evid Pediatr. 2020;16:15
Authors’ conclusions: despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.
Reviewers’ comment: the profile of patients in this study seems younger, of shorter evolution and milder than the group of patients expecting effective treatment at our hospitals. If the observed efficacy were reproduced in these patients, the treatment would be applicable in our setting. The effect size is high, although its clinical impact will depend on whether or not the virological clearance is associated with an improvement in clinical outcomes, such as respiratory failure or death. The quality of evidence is very low and the level of recommendation is weak in favor of the treatment.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2020;16:16
Conclusions of the authors of the study: tetravalent dengue vaccine (TAK-003) was efficacious against symptomatic dengue in countries in which the disease is endemic.
Reviewers’ comment: preliminary data suggest that the TAK-003 vaccine is efficacious and safe to prevent dengue. Although the vaccine would not be indicated in Spain, as it is not an endemic zone, it would be applicable in regions of America or Asia, as well as for travelers who are going to travel to risk areas.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2020;16:17
Authors’ conclusions: this meta-analysis does not provide evidence of the benefit of dietary treatment for autism spectrum disorder and only suggests limited potential effects of some interventions for the management of certain symptoms and clinical domains of the spectrum.
Reviewers’ commentary: supplementation with omega-3 fatty acids and vitamins in patients with autism spectrum disorder would not be generally justified. Vitamin supplementation may be reasonable for the treatment of some symptoms such as stereotypes. However, it might be interesting to propose an assessment of nutrients intake, aimed at adapting the intake of vitamins and other essential nutrients since their diet may be deficient.
Pérez-Moneo Agapito B, Molina Arias M. Evid Pediatr. 2020;16:18
Authors’ conclusions: omalizumab significantly reduced atopic dermatitis severity and improved quality of life in a pediatric population with atopy and severe eczema despite highly elevated total IgE levels at baseline. The result was associated with a potent topical corticosteroid sparing effect and may suggest that omalizumab is a treatment option for difficult-to-manage severe eczema in children with atopy.
Reviewers’ commentary: omalizumab is a treatment option for children over 6 years of age with severe atopic dermatitis and high IgE levels who do not respond to other treatments. The response to the treatment is moderate, allows for a reduction in the use of high-potency topical steroids, is maintained throughout the duration of the treatment and decreases in the weeks following the end of the treatment.
Aparicio Rodrigo M, Albi Rodríguez MS. Evid Pediatr. 2020;16:19
Authors’ conclusions: there was no significant difference in survival without moderate or severe neurodevelopmental disability at 24 months in very preterm or very-low-birth-weight infants with a strategy of advancing milk-feeding volumes in daily increments of 30 ml per kilogram as compared with 18 ml per kilogram.
Reviewers’ commentary: according to the analyzed study results, faster increments in milk volume (30 ml per kg / day) would not increase the risk of necrotizing enterocolitis, although the study reported a higher risk of moderate to severe motor disability. This finding could not be adequately explained and should be clarified in future research.
Authors’ conclusions: adolescents with emergency department visits for self-harm have higher rates of mortality, suicide and recurrent self-harm, as well as higher heath care cost, than matched controls. Development of algorithms and interventions than can identify and help adolescents at highest risk of recurrent self-harm is warranted.
Reviewers’ commentary: Those adolescents who presented to emergency departments with self-harm visits have higher rates of mortality from any cause, are also more likely to die by suicide, and are at increased risk of repeating self-harm emergency department visits or self-harm hospital admissions. Adolescents who were readmitted were more likely to be younger, to be female, to reside in a rural community, to have a personal medical history of abusing alcohol or other substances and to have a history of nearly every mental health concern. It is important to have sufficient treatment resources to develop interventions that can identify and help the adolescents at highest risk of recurrent self-harm.
Fraile Astorga G, González Rodríguez P. Evid Pediatr. 2020;16:21
Authors’ conclusions: the situation of chronic poverty in childhood affects 1 in 5 children in the United Kingdom. Exposure to poverty at an early age is related to a worse physical and mental health situation.
Reviewers’ conclusions: in a cohort of 10 652 children under the age of 14 recruited between 2000 and 2022 in the United Kingdom, called the Millennium Cohort Study (MCS), those exposed to poverty showed a higher risk of mental health problems, obesity and chronic diseases.
Esparza Olcina MJ, Flores Villar S. Evid Pediatr. 2020;16:22
Authors’ conclusions: administration of the first attenuated dose of measles vaccine before the 9th month, followed by one or two subsequent doses, results in an immune response similar to that other with an administration regimen with the first dose above 9 months, although there is some evidence of lower antibody titers in the first case. The relevance of this finding is uncertain.
Reviewers’ commentary: according to the results of the review, there are data in favor of the use of the first dose of attenuated measles vaccine at ages prior to 9 months, in the event of community outbreaks of the disease, but uncertainty arises as to whether this practice is appropriate in the long term.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2020;16:26
Editorial
