Authors´ conclusions: single-dose empiric antibiotic in the pediatric emergency department is an effective strategy to reduce the time from hospital arrival to antibiotic initiation and may help improve sepsis outcomes in children, reducing length of stay, duration of treatment, pediatric ICU admissions, and mortality.
Reviewers´ commentary: In patients with suspected sepsis, without clinical shock, antimicrobial therapy should be initiated as soon as possible, allowing up to 3 hours for diagnostic investigation and avoiding antibiotic treatment in non-bacterial infections or in non-infectious processes.
Balado Insunza MN, Aparicio Rodrigo M. Evid Pediatr. 2023;19:13
Authors´ conclusions: vitamin D supplementation for three years in school children with vitamin D deficiency results in increased serum levels with no impact on growth, body composition and pubertal development.
Reviewers´ commentary: although the population included in this study differs from the population in our setting, the results suggest that vitamin D supplementation should not be considered in this age range, at least in general, in the absence of other individualized indications.
Ochoa Sangrador C, Aparicio Rodrigo M. Evid Pediatr. 2023;19:14
Authors´ conclusions: there is a positive correlation between anti-transglutaminase IgA levels and the severity of intestinal mucosal changes in celiac patients. This correlation is not observed in patients with IgA deficiency who have elevated IgG antibodies. This supports the current recommendation to perform an intestinal biopsy in individuals with IgA deficiency despite high levels of anti-transglutaminase type IgG.
Reviewers´ commentary: although the study methodology does not allow assessing the capacity of anti-transglutaminase IgA antibodies for the diagnosis of celiac disease, it does support the current recommendations of always performing a biopsy in patients with IgA deficiency and suspicion of celiac disease.
Flores Villar S, Molina Arias M. Evid Pediatr. 2023;19:15
Authors´ conclusions: the intervention conditioned a reduction in the use of electronic media and resulted in a substantial increase in children's participation in physical activity. The large size of the effect suggests that the high number of children overusing recreational screens constitute a public health problem.
Reviewers´ commentary: the involvement of parents in reducing the use of screens in the family environment favors a less sedentary leisure time for their children, with more physical activity. The role of parents in improving their children's habits can be reinforced through primary care consultations. It would be interesting to carry out blinded studies, with a longer duration and larger sample size.
Fernández Rodríguez MM, Ruiz-Canela Cáceres J. Evid Pediatr. 2023;19:16
Authors´ conclusions: cryptorchid boys, particularly those with bilateral cryptorchidism who underwent orchiopexy, had altered levels of serum biomarkers of Sertoli cells and germ cells and smaller testicular volumes compared with controls.
Reviewers´ commentary: at the age of full pubertal maturation, boys who have required orchidopexy have a smaller testicular size than those with spontaneous descent and without cryptorchidism; in boys with bilateral cryptorchidism, FSH levels are higher and inhibin B levels are lower.
Rivero Martín MJ, Lojo Pons P. Evid Pediatr. 2023;19:17
Authors´ conclusions: this randomized clinical trial concludes that sending text messages to parents of school-aged children, promoting outdoor time and light exposure, reduced axial elongation and myopia progression over 3 years, being a promising strategy to reduce myopia.
Reviewers' commentary: sending informational text messages to parents of school-aged children to increase light exposure and outdoor time reduces the risk of myopia over 3 years. Therefore, it can be an appropriated strategy to apply in clinical practice, and also to be implemented by health services, to reduce the rising prevalence rate of myopia in recent years.
Balado Insunza MN, Martín Masot R. Evid Pediatr. 2023;19:18
Authors’ conclusions: although mRNA-vaccination against COVID-19 does seem to increase the myocarditis rates, the benefits of this immunization still overrate the risk of presenting myocarditis after vaccination.
Reviewers’ commentary: the risk-benefit balance favors vaccination. Nevertheless, close monitoring and record of adverse events must be continued.
Lemos Bouzas MX, Esparza Olcina MJ. Evid Pediatr. 2023;19:19
Authors´ conclusions: our results strongly support the use of chest radiography as a routine screening tool for the evaluation of child tuberculosis contacts. Radiographic abnormalities not usually considered suggestive of tuberculosis may indicate incipient or subclinical disease, although tuberculosis preventive treatment is adequate in most cases.
Reviewers´ commentary: data are lacking to properly assess the utility of chest radiography in tuberculosis exposed children. Abnormal chest radiography should alert us to the probable increased risk of the presence and/or development of the disease.