Authors´ conclusions: treatment with dulaglutide at a once-weekly dose of 0,75 mg or 1,5 mg was superior to placebo in improving glycemic control through 26 weeks among youths 10 to 17 years old with type 2 diabetes who were being treated with or without metformin or basal insulin, without an effect on BMI (body-mass index).
Reviewers´ commentary: treatment with dulaglutide among adolescents with type 2 diabetes is effective versus placebo with or without prior treatment. Given its high economic cost compared to metformin, it could be used as an alternative to treatment failure with metformin rather than as a first line option.
Rivero Martín MJ, Fraile Astorga G. Evid Pediatr. 2023;19:2
Authors´ conclusions: there is a decrease in the antibody response to main vaccines by consumption of antibiotics in children under two years.
Reviewers´ commentary: the results described warn of the possible lower effect of vaccines in children who use antibiotics too frequently. Until now it has not been proven that the observed reduction in antibody levels is accompanied by the development of diseases preventable by these vaccines.
Rodríguez-Salinas Pérez E, Balado Insunza MN. Evid Pediatr. 2023;19:3
Authors´ conclusions: children born during the first months of the imposition of isolation due to COVID-19 had less interaction with the non-direct family environment. This resulted in a delay in some of the development milestones, although the impact was not very important.
Reviewers´ commentary: this is one of the few studies that have been carried out on the impact of isolation by COVID-19 on those born then. It is a well-designed study, although it would be interesting if their investigations were extended over time to see how long it took these children to recover those developmental milestones.
Esparza Olcina MJ, Perdikidis Olivieri L. Evid Pediatr. 2023;19:4
Authors ́ conclusions: in children with acute illness who required non-invasive respiratory support in Pediatric Intensive Care Units the use of high-flow nasal cannulas was not inferior to the use of continuous positive airway pressure, with respect to the time of withdrawal of respiratory support.
Reviewers ́ commentary: there are doubts about the influence of the compared respiratory supports, different in complexity and discomfort, on the perception of treatment failure and its effect on decision making. Before making recommendations on the use of high-flow oxygen nasal cannula as initial therapy, its efficacy in preventing intubation and its cost-effectiveness should be assessed.
Authors´ conclusions: the authors propose a new score (derived from 8 risk factors) that identifies low risk children for invasive herpes simplex virus infection allowing to avoid routine tests or empirical unnecessary treatment in these cases.
Reviewers´ commentary: this study proposes a new score that classifies patients with less than 3 points into a low risk for invasive herpes simplex virus infection group avoiding unnecessary tests and treatments. Although the proposal is interesting, this score should be externally validated, and its specificity should be improved, before it is broadly implemented.
Lemos Bouzas MX, Ortega Páez E. Evid Pediatr. 2023;19:6
Authors´ conclusions: when compared to placebo or no treatment, probiotics may reduce the number of participants diagnosed with acute upper respiratory tract infections, may reduce the mean duration of an episode of acute URTIs, likely reduce the number of participants who used antibiotics for URTIs, and may not increase the number of participants who experienced at least one adverse event. The evidence regarding the number of participants who were absent from childcare centre, school, or work due to acute URTIs is very uncertain.
Reviewers´ commentary: according to the results of the meta-analysis, probiotics would be useful for the prevention of acute upper respiratory tract infections and their use could reduce the number of episodes and the number of days of infectious processes.
Flores Villar S, Cuestas Montañés EJ. Evid Pediatr. 2023;19:7
Authors´ conclusions: in this prospective cohort study, childhood cardiovascular risk factors and the change in the combined-risk z score between childhood and adulthood were associated with cardiovascular events in midlife.
Reviewers´ commentary: cardiovascular risk factors in childhood can lead to related disease and death in young adults. It should be considered a health priority to promote education programs for the primary prevention of cardiovascular risk factors in childhood and adolescence to reduce morbidity and mortality and the economic impact that cardiovascular disease has on society.
Authors´conclusions: probiotics could be beneficial in pediatric non-alcoholic fatty liver disease. Specifically, Lactobacillus acidophillus in combination with other strains of Bifidobacterium or Lactobacillus seem to reduce liver transaminases and improve anthropometric and cholesterol and triglycerides parameters when combined with lifestyle modifications.
Reviewers´commentary: treatment with probiotics may provide an additional benefit to the usual hygienic-dietary treatment by decreasing liver inflammation and possibly improving steatosis in a prevalent disease without other pharmacological treatment options.
Pérez-Moneo Agapito B, Ochoa Sangrador C. Evid Pediatr. 2023;19:9