Authors´ conclusions: exposure to any drug of dependency during pregnancy is associated with an increased risk of sudden infant death syndrome after controlling for socioeconomic factors. Further study to evaluate mechanisms and contribution of other confounders (e.g., smoking) is warranted.
Reviewers´ commentary: drug use during pregnancy increases the risk of sudden infant death syndrome, although there are other related factors that could modify the effect for which no adjustment has been made. Prevention of sudden infant death syndrome should focus on avoiding known risk factors, including drug use during pregnancy.
Fernández Rodríguez MM, González Rodríguez MP. Evid Pediatr. 2023;19:24
Authors´ conclusions: percutaneous tibial nerve stimulation with pelvic floor exercises is a safe and effective method in the treatment of childhood constipation, particularly in children with pelvic floor dysfunction or dyssynergic defecation.
Reviewers´ commentary: the data from the study suggest that percutaneous tibial nerve stimulation is an effective therapeutic option in children with constipation resistant to traditional medical treatment and pelvic floor dysfunction. Although it is not a technique available to the entire population, it could be an option to consider in selected patients. We should be cautious, the evidence is short in terms of the number of trials and sample size included in the studies, and we do not have data of persistence of the effect in the long term or of improvement in quality of life.
Fraile Astorga G, Aparicio Rodrigo M. Evid Pediatr. 2023;19:25
Authors´ conclusions: intermittent tiotropium bromide treatment may be an effective alternative to current therapies for episodic wheezing in infants and toddlers. Before implementation of use, further research on safety and efficacy is indicated.
Reviewers´ commentary: according to the results of this trial, it is not possible to confirm that tiotropium bromide produces relevant clinical improvement for episodic wheezing in infants and toddlers.
Sánchez Mateo A, Gimeno Díaz de Atauri Á. Evid Pediatr. 2023;19:26
Authors´ conclusions: expectant management for Patent Ductus Arteriosus in extremely premature infants was noninferior to early ibuprofen treatment with respect to necrotizing enterocolitis, bronchopulmonary dysplasia, or death at 36 weeks' postmenstrual age.
Reviewers' comment: although the study has low statistical power that limits its precision, its results reinforce previous evidence that does not support early treatment of patent ductus arteriosus with ibuprofen in extremely preterm infants. Expectant management shows similar results to ibuprofen at 36 weeks postmenstrual age without exposing newborns to possible drug side effects.
Carvajal Encina F, Aizpurua Galdeano P. Evid Pediatr. 2023;19:27
Authors´ conclusions: topical antibiotics were associated with significantly shorter durations of conjunctival symptoms in children with acute infective conjunctivitis.
Reviewers' comment: the use of topical antibiotics modestly benefits the patient, shortening the clinical cure in acute conjunctivitis. However, given the self-limited course of this pathology and the lack of cost-effectiveness studies in this area, its generalized prescription in primary care does not seem justified. Such studies should be carried out to assess the overall impact on society of the treatment of these patients.
Blanco Rodríguez C, Aizpurua Galdeano P. Evid Pediatr. 2023;19:28
Authors´ conclusions: overweight and obesity were associated with the amount of time spent viewing digital appliances in children between 2 and 14 years of age. These results should be confirmed by means of prospective studies, since it is probable that as the time spent in this way increases, so does the risk of being overweight and developing obesity.
Reviewers´ commentary: screen time spent for three or more hours in childhood was associated with greater prevalence of overweight and obesity. Restricting the use of this type of appliances and promoting other alternative activities such as physical activity and healthy life styles, could reduce the prevalence of overweight and obesity.
Perdikidis Olivieri L, Ortega Páez E. Evid Pediatr. 2023;19:29
Authors´ conclusions:Psyllium husk is effective for the therapy of pediatric irritable bowel syndrome (IBS) when compared with placebo in short term.
Reviewers´ commentary: the present study uses a score, as a measure of the main result, that has not been validated in the pediatric populations, nor does it take into account variables such as fiber consumption or psychological status prior to the study. Given these factors, the results of the study may have a great bias that, in our opinion, neither support nor contradict the use of Psyllium for the treatment of children with IBS.
Llerena Santa Cruz E, Rodríguez-Salinas Pérez E. Evid Pediatr. 2023;19:30
Authors’ conclusions: initiation of treatment with oral propranolol before 10 weeks of age was associated with a better success. Early referral should be made so they can be treated as soon as possible.
Reviewers’ commentary: data analysis suggests an improvement in the success rate of propranolol if initiated before 10 weeks; an implementable measure; nonetheless, it is necessary to check the rule´s external validity.
Albi Rodríguez MS, Esparza Olcina MJ. Evid Pediatr. 2023;19:31