Pediatrics

Families value treatment recommendations in pediatric precision medicine despite mixed recall.

In the Australian PRISM trial, parents and adolescents with poor‑prognosis cancer commonly expected benefit and treatment recommendations at enrolment. Of parents, 70% received a treatment recommendation but only about half recalled that information at follow-up. Parents reported high involvement (93/100) and high satisfaction (95/100) with treatment decisions after recommendations. Receiving a treatment recommendation was not associated with trial-regret (p > 0.05). 1

Single prophylactic buccal dextrose gel at 1 hour did not improve school‑age neurocognition and had possible harms.

In the hPOD randomized trial follow-up, neurocognitive impairment at 6–7 years was similar between dextrose gel and placebo (59% vs 57%; aRD 3%, 95% CI -3% to 9%). Exploratory outcomes showed higher emotional‑behavioral difficulty (24% vs 18%; aRD 7%, 95% CI 1%–12%) after dextrose gel. Psychosocial function was more often low after dextrose gel (17% vs 12%; aRD 6%, 95% CI 1%–10%). These results do not support routine use of a single prophylactic dextrose gel dose for at‑risk newborns. 2

Adolescents with CHD have graded increases in failing upper secondary qualification by CHD severity.

This Swedish total‑population cohort found higher failure rates for upper secondary qualification across CHD severity levels versus peers without CHD. Adjusted absolute excess risks were 11, 7, 6, and 2 additional children per 100 for univentricular, severe, moderate, and mild CHD, respectively. Results persisted in sibling analyses and over time, and were worse when noncardiac anomalies coexisted. Clinicians should recognize higher academic risk among adolescents with CHD and consider early educational supports. 3