Two recent studies investigated the use of corticosteroids for children with virus-induced wheezing.  Oral prednisolone was compared to placebo in a randomized trial with 700 children aged 10-60 months who had mild-to-moderate wheezing.  Prednisolone, 10 mg for children ≤ 24 and 20 mg for older children, was given once daily for 5 days.  There were no significant differences between groups in length of hospitalization, 7-day symptom scores, 7-day respiratory assessment scores, albuterol use or adverse events (level 2 [mid-level] evidence) (N Engl J Med 2009 Jan 22;360(4):329).  Another randomized trial evaluated the use of intermittent high-dose fluticasone in 129 children aged 1-6 years with recurrent virus-induced wheezing.  Children received either 750 micrograms of fluticasone (in 3 inhalations) or placebo twice daily beginning at the onset of upper respiratory tract infection and continuing until the child was cough- and wheeze-free for 48 hours (up to a maximum of 10 days).  At median follow-up of 40 weeks, children in the fluticasone group were significantly less likely to have required rescue systemic corticosteroids and infections in the fluticasone group averaged 1 day shorter than infections in the placebo group (level 1 [likely reliable] evidence).  Fluticasone was associated with slightly smaller mean gains in height and weight, but there were no significant differences in basal cortisol level, bone mineral density or adverse events (N Engl J Med 2009 Jan 22;360(4):339).  For more information, see the Corticosteroids for wheezing in children topic in DynaMed.

A randomized trial compared laparoscopic and open surgery in 90 children aged 4 months to 16 years with unilateral inguinal hernia.  Laparoscopic repair was associated with longer times in the operating room (63 vs. 38 minutes, p < 0.001) and day surgery ward (300 vs. 230 minutes, p < 0.001) and with greater need for postoperative rescue analgesia (79% vs. 42%, p < 0.05, NNH 27) (level 1 [likely reliable] evidence).  Median pain scores on the second postoperative morning were also significantly higher for the laparoscopic group.  At 2 year follow-up, there were no differences in recurrent hernia or cosmetic outcome (Pediatrics 2009 Jan;123(1):332).  For more information, see the Groin hernia in children topic in DynaMed.