Authors´ conclusions: the early introduction of egg or peanut to the infant diet was associated with lower risk of developing egg or peanut allergy. These findings should be considered in the context of limitations in the primary studies
Reviewers´ commentary: there is probably no justification for the delay in the introduction of some foods such as eggs and peanuts to prevent allergy to them. This recommendation can even be harmful. There is no evidence to make a recommendation on the most appropriate time to introduce them
Aparicio Rodrigo M, Albi Rodríguez MS. Evid Pediatr. 2016;12:59
Authors’ conclusions: we demonstrate that swallowed fluticasone is effective as long-term maintenance therapy for children with eosinophilic esophagitis, without growth impediment or serious side effects.
Reviewers’ commentary: swallowed fluticasone is effective as maintenance therapy in children with eosinophilic esophagitis. Additional research is needed to assess aspects related to growth adverse effects.
Authors’ conclusions: a BMI in the 50th to 74th percentiles, within the accepted normal range, during adolescence was associated with increased cardiovascular and all-cause mortality during 40 years of follow-up. Overweight and obesity were strongly associated with increased cardiovascular mortality in adulthood.
Reviewers’ commentary: this paper provides further evidence on the prognosis of obesity in adolescence. Furthermore, it adds some uncertainty on BMI threshold for cardiovascular risk, because a BMI in the 50th to 74th percentiles does not look safe.
Esparza Olcina MJ, Aizpurua Galdeano P. Evid Pediatr. 2016;12:61
Authors´ conclusions: there is strong evidence to support daily ICS (inhaled corticosteroids) for preventing exacerbations in preschool children with recurrent wheeze, specifically in children with persistent asthma. For preschool children with intermittent asthma or viral triggered wheezing, there is strong evidence to support intermittent ICS for preventing exacerbations.
Reviewers´ commentary: clearly the use of daily ICS is effective in the prevention of exacerbations in children with persistent asthma. For intermittent or viral URTIs (Upper respiratory tract infections) induced exacerbations of asthma, high-dose intermittent ICS appear to play an important role in preventing severe exacerbations.
Martínez Rubio M.V, Juanes de Toledo B. Evid Pediatr. 2016;12:62
Authors´ conclusions: higher albuterol dosage regimens, compared to lower ones, did not result in lower admission rate or shorter length of stay in the ER, but showed similar safety profile for children with moderate to severe acute asthma.
Reviewers´ commentary: in children with moderate or severe asthmatic exacerbations, treatment with 600 mcg of albuterol, administered with a spacer, seems to be as effective and safe as higher dosage regimens, although there could be real differences that haven’t been real differences that haven’t been found, because of lack of statistical power. It would be interesting to study if even lower doses are also effective, and if there are differences of effectiveness depending on the severity.
Gimeno Díaz de Atauri Á, Castillo Campos L. Evid Pediatr. 2016;12:63
Authors’ conclusions: no long-term benefit was demonstrated, in terms of allergic diseases reduction, for the children of mothers who received n-3 LCPUFA supplementation during pregnancy. In the assessment at six years of age, only a minor protective effect was found, against sensitization to one specific allergen (Dermatophagoides farinae)
Reviewers’ commentary: in line with the most recent systematic reviews, this trial, with some methodological problems (designed for the study of other variable result), demonstrated the lack of utility of n-3 LCPUFA supplements in pregnant women, to prevent allergic diseases in their children, at the age of six years.
Authors´ conclusions: widespread use of varicella vaccine could reduce herpes zoster incidence among vaccinated populations. Ongoing monitoring of herpes zoster incidence is needed to detect and understand changes in herpes zoster epidemiology in the varicella vaccine era.
Reviewers´ commentary: a vaccination program against chickenpox in early childhood is associated with a reduction in the incidence of herpes zoster in the first ten years of life. The initial increase observed in children older than ten years and adolescents, partially vaccinated, tends to be reversed and could be the consequence of a delay in the appearance of the disease rather than a real increase.
Ochoa Sangrador C, Andrés de Llano JM. Evid Pediatr. 2016;12:65
Authors´ conclusions: among children with mild persistent asthma, as-needed use of acetaminophen was not found associated with higher incidence of asthma attacks or with worse asthma control than was as-needed use of ibuprofen.
Reviewers´ commentary: this is a well-designed trial that shows no difference in the use of acetaminophen or ibuprofen with respect to asthma attacks or asthma control. There was no placebo group for ethical issues and we cannot know whether or not there is a causal relationship between the use of those drugs and worsening of the course of asthma or worse asthma control, but given the available evidence does not seem sensible to restrict their use in children with asthma.
Martín Masot R, Ortega Páez E. Evid Pediatr. 2016;12:66
Authors´ conclusions: the results of the study provide preliminary data on the diagnostic accuracy of the test described for the distinction between bacterial and viral infection in children with fever
Reviewers´ commentary: this study offers preliminary data on a test using a RNA biomarker. Although it seems to differentiate between bacterial and viral infections, the available information does not allow to evaluate its clinical utility. It is necessary to demonstrate its usefulness in different scenarios, such as emergency services or primary care, and to assess its contribution in reducing the use of antibiotics with a more accurate diagnosis of bacterial infection.
Ruiz-Canela Cáceres J, García Vera C. Evid Pediatr. 2016;12:67
Editorial
