Authors´ conclusions: non-laboratory-based risk factors and lipids measured in adolescence independently predicted adult cardiovascular events. The addition of lipid measurements to non-laboratory risk factors did not improve the prediction of cardiovascular events.
Reviewers´ commentary: the detection of cardiovascular risk factors in childhood predicts the cardiovascular events in adulthood. The indiscriminate use of blood lipid measurement is not indicated because it does not provide benefits in the prediction of cardiovascular risk or in the prescription of preventive measures.
Rivero Martín MJ, Oltra Benavent M. Evid Pediatr. 2025;21:27
Authors´ conclusions: in acute non perforated appendicitis, antibiotic treatment was inferior to appendectomy in preventing cumulative treatment failure. Appendectomy resulted in shorter hospital stays and fewer subsequent emergency department visits, but antibiotic treatment resulted in a shorter convalescence period and a faster return to normal daily activities.
Reviewers´ commentary: conservative treatment with antibiotics was inferior to surgical treatment of non-perforated appendicitis by appendectomy, so when explaining the therapeutic options for this specific process, this fact observed in this study is not negligible when deciding on treatment for acute non-perforated appendicitis.
Cabrera Morente L, Flores Villar S. Evid Pediatr. 2025;21:28
Authors´ conclusions: this systematic review and meta-analysis found inverse associations and a dose-response association between fluoride measurements in urine and drinking water and children's intelligence quotient across the large multicounty epidemiological literature. There were limited data and uncertainty in the dose-response association between fluoride exposure and children's intelligence quotient when fluoride exposure was estimated by drinking water alone at concentrations less than 1.5 mg/l.
Reviewers´ commentary: although there is evidence of an inverse relationship between fluoride exposure and child intelligence quotient, the effect is small, especially in studies with low risk of bias. More research is needed to better understand the dose-response relationship, identify vulnerable groups, and assess long-term impact. The interpretation of the findings should be cautious, taking into account the methodological limitations and the heterogeneity observed in the studies.
Authors ́ conclusions: lung ultrasound has a high accuracy for diagnosing community-acquired pneumonia in children. This diagnostic tool has proven advantages over chest X-ray.
Reviewers ́ commentary: lung ultrasound performed by moderately or highly experienced personnel has very good performance in various healthcare settings, suggesting that it could be a viable alternative to chest X-ray. The lack of a gold standard and differences in diagnostic criteria prevent clear conclusions. The varying prevalence of pneumonia and vaccination coverage across studies partially limit the extrapolation of these data to our setting.
Albi Rodríguez MS, Blanco Rodríguez C. Evid Pediatr. 2025;21:30
Authors´ conclusions: the risk of choking does not seem to be associated with the complementary food approach. Instead, it may be related to the familiarity of the baby with each texture and the parent's understanding of the information about how to minimize the risk of choking.
Reviewers´ commentary: although the risk of choking is similar between the complementary feeding methods evaluated, the number of choking episodes were more frequent with solid food consistency. The heterogeneity and lack of clear definition between choking and gagging make the results not so reliable.
Llerena Santa Cruz E, Aparicio Rodrigo M. Evid Pediatr. 2025;21:31
Authors’ conclusions: in neonates with coagulase-negative staphylococcus bacteremia, continuous vancomycin infusion, compared to intermittent dosing, was associated with a lower rate of therapeutic failure and a shorter time to reach therapeutic levels, without increasing renal toxicity.
Reviewers’ comments: continuous vancomycin infusion is feasible in NICUs with adequate resources. Preterm neonates with coagulase-negative staphylococcus sepsis and vascular access would be ideal candidates. Although promising, its implementation as a standard of care requires further evidence, ideally from multicenter randomized clinical trials.
Authors´ conclusions: rotavirus vaccines are highly effective in preventing emergency department visits or hospitalizations in children aged 8–59 months. Efficacy was highest for more severe disease and conferred protection against common circulating genotypes, even those not included in the vaccine. Effectiveness is highest in children under 3 years of age. These findings highlight the importance of continued investment in routine immunization to prevent severe rotavirus disease in US children.
Reviewers´ commentary: rotavirus vaccines continue to be effective in preventing rotavirus-associated emergency department visits and hospitalizations for the most common genotypes found in this study (G1P8, G2P4, G3P8, G9P8, and G12P8). This study reinforces the importance of continuing to promote high vaccination coverage and monitoring the different genotypes that cause severe infection.
Gutiérrez Medina P, Aparicio Rodrigo M. Evid Pediatr. 2025;21:33
Authors’ conclusions: the “Safer Childbirth Care Program” showed that quality improvement in the setting of childbirth-related emergencies in low-resource settings is associated with a significant decrease in perinatal mortality.
Reviewers’ commentary: despite the study's methodological limitations, the integrated quality improvement and simulation care program had significant results in childbirth-related emergencies in resource-limited settings.
Carvajal Encina F, Fernández Rodríguez MM. Evid Pediatr. 2025;21:34
Critically appraised articles
