Authors’ conclusions: a beneficial response to treatment for pediatric obesity significantly reduces the risks of morbidity and mortality, with a relationship between the degree of response and the rate of complications in young adulthood. The study demonstrated a marked decrease in the risk of type 2 diabetes and dyslipidemia, although the outcome of obesity treatment does not appear to influence other factors such as the presence of depression or anxiety.
Reviewers’ commentary: although the benefit of obesity treatment is clear, data are lacking to adequately estimate the medium-term effect of body mass index normalization in children aged 6 to 17 years. Even after remission, the incidence rate of cardiovascular events remained higher, highlighting the importance of treatment and prevention.
Authors´ conclusions: among children with gastroenteritis-associated vomiting, the provision of ondansetron after a pediatric emergency department visit led to lower risk of moderate-to-severe gastroenteritis during the subsequent 7 days compared with placebo.
Reviewers´ commentary: despite a well-designed and methodologically sound study, the results of home ondansetron in cases of acute gastroenteritis have not demonstrated a clinically relevant impact sufficient to warrant changes in our current therapeutic practice.
Suárez Cabezas S, Llerena Santa Cruz E. Evid Pediatr. 2026;22:2
Authors’ Conclusions: study concludes that the use of pancreatic enzyme therapy is associated with a reduction in incidence of recurrent acute pancreatitis and chronic pancreatitis in children. Genetic factors may influence response to treatment.
Reviewers´ comments: although this study concludes that pancreatic enzymes are effective in preventing disease progression in children with recurrent or chronic pancreatitis, its methodological characteristics do not allow us to recommend changes in management of these patients without experimental studies to support these results.
Authors ́ conclusions: hydroxychloroquine, treatment showed the greatest evidence for preventing congenital atrioventricular block, although this was obtained from studies with a high risk of bias and imprecision.
Reviewers ́ commentary: prophylactic treatment with hydroxychloroquine in pregnant women with positive anti-Ro/La for autoimmune-mediated congenital heart block presents limited evidence. Given the low toxicity observed and the severity of the effect without treatment, the use of chloroquine may be justified until higher quality studies are available.
Oltra Benavent M, Blanco Rodríguez C. Evid Pediatr. 2026;22:4
Authors’ conclusions: there is low-to-very-low certainty evidence demonstrating the superiority of any intravenous second-line treatment options for acute asthma.
Reviewers’ commentary: among pediatric patients with a severe asthma exacerbation, the evidence supporting the use of intravenous second-line-treatment when first line treatment fails, remains limited. Current data indicate that magnesium sulfate exhibits the most substantial efficacy; nonetheless, further high-quality studies are warranted to establish robust recommendations for its broader clinical application.
Authors’ conclusions: children with febrile urinary tract infections (UTI) assigned to individualized treatment duration had an increased risk of recurrent UTI (by 5.3 percentage points) but reduced antibiotic use and fewer adverse event days within 28 days compared with those assigned to standard 10-day treatment.
Reviewers’ commentary: while individualized duration treatment reduces antibiotic expo-sure and side effects in children with febrile UTIs, it did not demonstrate non-inferiority, presenting a higher risk of recurrent infection (one in 19 patients compared to standard duration treatment). Therefore, further research is needed to establish its safety.
Carvajal Encina F, Pérez González E. Evid Pediatr. 2026;22:6
Critically appraised articles
