Reporting guidelines and a touch of critical appraisal.

The biomedical research process must follow certain quality criteria in its design and development to ensure that the results are credible and reliable. Once completed, the time comes to write an article for publication. The article must present in sufficient detail, and in a clear and transparent manner, all the information on the research work that has been carried out. In this way, readers, after a critical reading of the published content, will be able to judge the validity and relevance of the study and, if they so wish, make use of the findings. In order to improve the description of the research process for publication, a series of guidelines have been developed which, in a simple and structured way, guide authors in the preparation of a manuscript. They are presented in the form of a list, flowchart, or structured text, and are an invaluable aid when writing an article. This article presents the reporting guidelines for the most common designs along with the corresponding checklists.

Guías para la elaboración de manuscritos y unas pinceladas de lectura crítica / Reporting guidelines and a touch of critical appraisal

El proceso de investigación biomédica debe seguir unos criterios de calidad en su diseño y elaboración que garanticen que los resultados son creíbles y fiables. Una vez finalizado, llega el momento de escribir un artículo para su publicación. Este debe presentar con suficiente detalle, y de forma clara y transparente, toda la información del trabajo de investigación realizado. De esta forma, los lectores, tras una lectura crítica de lo publicado, podrán juzgar la validez y la relevancia del estudio, y si lo consideran, utilizar los hallazgos. Con el objetivo de mejorar la descripción del proceso de investigación para su publicación, se han desarrollado una serie de guías que, de forma sencilla y estructurada, orientan a los autores a la hora de elaborar un manuscrito. Se presentan en forma de lista, diagrama de flujo, o texto estructurado, y son una ayuda inestimable a la hora de escribir un artículo. Este artículo presenta las guías de elaboración de manuscritos de los diseños más habituales, con sus listas de verificación.(AU)

The biomedical research process must follow certain quality criteria in its design and development to ensure that the results are credible and reliable. Once completed, the time comes to write an article for publication. The article must present in sufficient detail, and in a clear and transparent manner, all the information on the research work that has been carried out. In this way, readers, after a critical reading of the published content, will be able to judge the validity and relevance of the study and, if they so wish, make use of the findings. In order to improve the description of the research process for publication, a series of guidelines have been developed which, in a simple and structured way, guide authors in the preparation of a manuscript. They are presented in the form of a list, flowchart, or structured text, and are an invaluable aid when writing an article. This article presents the reporting guidelines for the most common designs along with the corresponding checklists.(AU)

En niños, ¿se puede acortar el tratamiento de la neumonía adquirida en la comunidad a 3 días? / Is it possible to use a shortened 3-day course of treatment for community-acquired pneumonia in children?

Conclusiones de los autores del estudio: en relación con la necesidad de retratamiento con antibióticos en niños con neumonía adquirida en la comunidad dados de alta de un servicio de urgencias hospitalarias o de la planta de hospitalización tras ingreso de menos de 48 horas de duración, el uso de dosis bajas de amoxicilina no fue inferior frente a dosis altas, al igual que la duración de 3 días no fue inferior frente a 7 días. Conclusiones de los revisores: los datos de este estudio invitan a revisar en nuestro entorno las pautas que se utilizan en niños en el tratamiento de neumonía en la comunidad, en cuanto a la menor duración del tratamiento y dosificación que podría conllevar beneficios, pero hay limitaciones de este estudio para que sus conclusiones sean aplicables a nuestro país (AU)

Authors' conclusions: as concerns the need for antibiotic retreatment in children with community-acquired pneumonia discharged from the emergency department or inpatient ward within 48 hours of admission, lower-dose outpatient oral amoxicillin was non-inferior to high-dose amoxicillin, and a 3-day course was non-inferior to a 7-day course.Reviewers' conclusions: the data from this study invite a revision of the guidelines used in our region for the treatment of community-acquired pneumonia in children, with the purpose of clarifying if a shorter duration of treatment and lower dose could be beneficial, but there are limitations to the study for its conclusions to be applicable in our country. (AU)

Abordaje terapéutico de la otitis media aguda en atención primaria de un área urbana. Evaluación de la prescripción diferida de antibióticos / Therapeutic approach to acute otitis media in primary care in an urban area. Delayed antibiotic prescription evaluation

ntroducción: La otitis media aguda (OMA) es una de las causas más frecuentes de consulta y prescripción antibiótica en pediatría. El objetivo de este trabajo es valorar la prescripción antibiótica diferida en OMA en pediatría en atención primaria. Material y métodos: Estudio observacional, retrospectivo, mediante revisión de historias clínicas en un centro de salud urbano de la Comunidad Autónoma de Aragón de niños con OMA de tres cupos en los que los facultativos realizan prescripción diferida. Mediante regresión logística se analizan las variables posiblemente relacionadas con la prescripción antibiótica. Resultados: Se analizan 1.390 episodios de OMA en 696 pacientes. Se realizó prescripción inmediata de antibióticos en el 67,6% (IC 95% 65,1-70,0) de episodios, sintomática exclusiva en el 13,7% (IC 95% 11,9-15,6) y antibiótica diferida en el 18,7% (IC 95% 16,7-20,8), dispensándose finalmente el antimicrobiano en el 53,5% (IC 95% 47,4-59,5) de estos últimos. Factores relacionados significativamente con la adquisición final antimicrobiana en prescripción diferida son la edad entre 0-2 años (OR 1,89; IC 95% 1,25-2,87), la bilateralidad (OR 2,54; IC 95% 1,48-4,35), la otalgia (OR 0,49; IC 95% 0,29-0,82), la fiebre (OR 2,67; IC 95% 1,95-3,65), el abombamiento (OR 3,63; IC 95% 2,50-5,29) y la otorrea (OR 25,98; IC 95% 12,75-52,92). Los mismos factores influyen en la prescripción global de antibióticos. Se indicó principalmente amoxicilina (74,6%), seguido de amoxicilina-clavulánico (17,0%).Conclusiones: La prescripción diferida en OMA parece útil para disminuir el consumo de antibióticos, siendo necesario avanzar en su implantación. (AU)

Background and objectives: Acute otitis media (AOM) is one of the most frequent causes of consultation and antibiotic prescription in pediatrics. The objective of this work is to evaluate the practice of delayed antibiotic prescription in AOM in pediatrics primary care. Material and methods: Observational, retrospective study, through reviewing of medical records in a primary care center of Aragon Community of children with OMA in which doctors perform delayed prescription. Logistic regression analyzes possibly related to antibiotic prescription factors. Results: 1,390 episodes of AOM are analyzed in 696 patients. Immediate antibiotic prescription is performed in 67.6% (95% CI 65.1-70.0) of episodes, exclusive symptomatic in 13.7% (95% CI 11.9-15.6), and delayed antibiotic in 18.7% (95% CI 16.7-20.8), finally being given in 53.5% (95% CI 47.4-59.5) of these. Factors significantly related to final antimicrobial dispensation in delayed prescription are aged between 0 and 2 years (OR 1.89, 95% CI 1.25-2.87), bilaterality (OR 2.54, 95% CI 1.48-4.35), ear pain (OR 0.49, 95% CI 0.29-0.82), fever (OR 2.67, 95% CI 1.95-3.65), bulging (OR 3.63, 95% CI 2.50-5.29) and otorrhea (OR 25.98, 95% CI 12.75-52.92). The same factors have influence on global prescription of antibiotics. Amoxicillin (74.6%) is the most indicated antibiotic, followed by amoxicillin–clavulanic (17.0%).Conclusions: Delayed prescription in AOM seems to be useful to reduce antibiotics consumption, being necessary to advance in its implantation. (AU)

El uso frecuente de productos de limpieza en los primeros meses de vida incrementa el riesgo de sibilancias recurrentes a los tres años / Frequent use of household cleaning products in the first months of life increases the risk of recurrent wheezing at three years

Conclusiones de los autores del estudio: el uso frecuente de productos de limpieza en los hogares de lactantes está asociado con un riesgo aumentado de sibilantes y asma, pero no con atopia, a los tres años, indicando un posible efecto inflamatorio en las vías respiratorias, no una respuesta alérgica adquirida. Comentario de los autores de la revisión: los datos de este estudio sugieren que la limpieza con productos domésticos se asocia con una mayor incidencia de sibilancias recurrentes y asma en uno de cada tres niños de tres años. Pero la calidad media del estudio deja abierta la incógnita para la ulterior investigación sobre si los productos domésticos comunes puedan preparar las vías respiratorias para una futura enfermedad pulmonar alérgica

Authors' conclusions: frequent use of household cleaning products in the home in early infancy is associated to an increased risk of wheezing and asthma in children, but not of atopy, at three years, showing a possible inflammatory effect in the respiratory tract, not an allergic acquired response. Reviewers' conclusions: the study results suggest that the use of cleaning products is associated with a higher incidence of recurrent wheezing and asthma in one in three children at the age of three years. But the medium level of quality of the study leaves the question open for further research, to try to clarify if common cleaning products could be preparing respiratory tract for future allergies

[Therapeutic approach to acute otitis media in primary care in an urban area. Delayed antibiotic prescription evaluation]. / Abordaje terapéutico de la otitis media aguda en atención primaria de un área urbana. Evaluación de la prescripción diferida de antibióticos.

BACKGROUND AND OBJECTIVES: Acute otitis media (AOM) is one of the most frequent causes of consultation and antibiotic prescription in pediatrics. The objective of this work is to evaluate the practice of delayed antibiotic prescription in AOM in pediatrics primary care. MATERIAL AND METHODS: Observational, retrospective study, through reviewing of medical records in a primary care center of Aragon Community of children with OMA in which doctors perform delayed prescription. Logistic regression analyzes possibly related to antibiotic prescription factors. RESULTS: 1,390 episodes of AOM are analyzed in 696 patients. Immediate antibiotic prescription is performed in 67.6% (95% CI 65.1-70.0) of episodes, exclusive symptomatic in 13.7% (95% CI 11.9-15.6), and delayed antibiotic in 18.7% (95% CI 16.7-20.8), finally being given in 53.5% (95% CI 47.4-59.5) of these. Factors significantly related to final antimicrobial dispensation in delayed prescription are aged between 0 and 2 years (OR 1.89, 95% CI 1.25-2.87), bilaterality (OR 2.54, 95% CI 1.48-4.35), ear pain (OR 0.49, 95% CI 0.29-0.82), fever (OR 2.67, 95% CI 1.95-3.65), bulging (OR 3.63, 95% CI 2.50-5.29) and otorrhea (OR 25.98, 95% CI 12.75-52.92). The same factors have influence on global prescription of antibiotics. Amoxicillin (74.6%) is the most indicated antibiotic, followed by amoxicillin-clavulanic (17.0%). CONCLUSIONS: Delayed prescription in AOM seems to be useful to reduce antibiotics consumption, being necessary to advance in its implantation.

¿Ha disminuido la actividad de Atención Primaria dentro del congreso de la Asociación Española de Pediatría?. Respuesta / No disponible

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Consenso español sobre el hemangioma infantil / Spanish consensus on infantile haemangioma

INTRODUCCIÓN: Los hemangiomas infantiles son tumores benignos producidos por la proliferación de células endoteliales de vasos sanguíneos, con una alta incidencia en niños menores de un año (4-10%) y se estima que un 12% de ellos requiere tratamiento. Dicho tratamiento debe realizarse según las guías de práctica clínica y la experiencia de los especialistas, las características de los pacientes y las preferencias de sus progenitores. MÉTODOS: El proceso de consenso se realizó utilizando evidencias científicas sobre el diagnóstico y tratamiento de los hemangiomas infantiles, extraídas mediante una revisión sistemática de la literatura, junto con el juicio experto de los especialistas. Las recomendaciones formuladas fueron validadas por los especialistas, aportando su grado de acuerdo. RESULTADOS: El presente documento recoge recomendaciones sobre la clasificación, las asociaciones, las complicaciones, el diagnóstico, el tratamiento y el seguimiento de los pacientes con hemangioma infantil. Además, se incluyen algoritmos de actuación y se aborda el manejo multidisciplinario y criterios de derivación entre los distintos especialistas que participan en el manejo clínico de este tipo de pacientes. CONCLUSIONES: Las recomendaciones y los algoritmos diagnóstico y terapéutico de los hemangiomas infantiles recogidos en este documento son una herramienta útil en el manejo adecuado de estos pacientes

INTRODUCTION: Infantile haemangiomas are benign tumours produced by the proliferation of endothelial cells of blood vessels, with a high incidence in children under the age of one year (4-10%). It is estimated that 12% of them require treatment. This treatment must be administered according to clinical practice guidelines, expert experience, patient characteristics and parent preferences. METHODS: The consensus process was performed by using scientific evidence on the diagnosis and treatment of infantile haemangiomas, culled from a systematic review of the literature, together with specialist expert opinions. The recommendations issued were validated by the specialists, who also provided their level of agreement. RESULTS: This document contains recommendations on the classification, associations, complications, diagnosis, treatment, and follow-up of patients with infantile haemangioma. It also includes action algorithms, and addresses multidisciplinary management and referral criteria between the different specialities involved in the clinical management of this type of patient. CONCLUSIONS: The recommendations and the diagnostic and therapeutic algorithms of infantile haemangiomas contained in this document are a useful tool for the proper management of these patients

[Spanish consensus on infantile haemangioma]. / Consenso español sobre el hemangioma infantil.

INTRODUCTION: Infantile haemangiomas are benign tumours produced by the proliferation of endothelial cells of blood vessels, with a high incidence in children under the age of one year (4-10%). It is estimated that 12% of them require treatment. This treatment must be administered according to clinical practice guidelines, expert experience, patient characteristics and parent preferences. METHODS: The consensus process was performed by using scientific evidence on the diagnosis and treatment of infantile haemangiomas, culled from a systematic review of the literature, together with specialist expert opinions. The recommendations issued were validated by the specialists, who also provided their level of agreement. RESULTS: This document contains recommendations on the classification, associations, complications, diagnosis, treatment, and follow-up of patients with infantile haemangioma. It also includes action algorithms, and addresses multidisciplinary management and referral criteria between the different specialities involved in the clinical management of this type of patient. CONCLUSIONS: The recommendations and the diagnostic and therapeutic algorithms of infantile haemangiomas contained in this document are a useful tool for the proper management of these patients.

Documento de consenso sobre la utilización de antibióticos en atención primaria / Consensus document on the use of antibiotics in primary care

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