Every week, I save a stack of articles, papers, and posts that catch my eye – sometimes it’s cutting-edge PEM research, sometimes a great essay or think piece I stumble across mid-scroll. Instead of letting them live forever in my “read later” folder, I’m sharing a few highlights here.
Each piece includes a TL;DR summary for the quick take and a 1-minute summary if you want a bit more context – both AI-generated (via ChatGPT-5) but curated by me for accuracy and relevance.
Grab a coffee, scroll through, and see what stands out to you this week.
1. Derivation and Validation of Predictive Models for Early Pediatric Sepsis. JAMA Pediatr. 2025 Oct 13:e253892. doi: 10.1001/jamapediatrics.2025.3892. Epub ahead of print. PMID: 41082207; PMCID: PMC12519407.
TL;DR: AI models using ED data predicted pediatric sepsis up to two days early with strong accuracy – a potential game-changer for early recognition.
1-minute summary: This JAMA Pediatrics study from the PECARN network trained AI models on millions of pediatric ED encounters to forecast sepsis before it shows itself. The top model reached an AUROC of 0.94, accurately flagging children likely to develop sepsis or shock within 48 hours. It’s a promising step toward integrating machine learning into early sepsis recognition – but still one that needs thoughtful clinical oversight.
2. Electrolyte Imbalance in Infants Younger Than 90 Days of Age With Febrile Urinary Tract Infection. Acta Paediatr. 2025 Aug 29. doi: 10.1111/apa.70291. Epub ahead of print. PMID: 40879221.
TL;DR: Electrolyte or kidney abnormalities are rare in well-appearing febrile infants under 90 days with UTI – mild hyponatremia is common, but true renal impairment is almost nonexistent.
1-minute summary: This Acta Paediatrica study analyzed over 2,300 febrile infants under 90 days old to assess electrolyte and kidney function changes in those with UTI. The vast majority had normal labs, and only mild hyponatremia appeared frequently without clinical consequence. No cases of acute kidney injury were found, and abnormalities were mainly seen when invasive bacterial infection was also present. The takeaway: routine electrolyte or renal testing in well-appearing infants with short-duration febrile UTI may not be necessary.
3. Reevaluating Nonoperative Management for Pediatric Uncomplicated Acute Appendicitis: A Systematic Review and Meta-Analysis. JAMA Pediatr. 2025 Oct 5:e254091. doi: 10.1001/jamapediatrics.2025.4091. Epub ahead of print. PMID: 41046476; PMCID: PMC12498239.
TL;DR: Nonoperative management (antibiotics alone) for uncomplicated pediatric appendicitis failed more often and caused more major complications than surgery – while recovery was slightly faster, long-term outcomes favored appendectomy.
1-minute summary: This JAMA Pediatrics meta-analysis reviewed seven RCTs including 1,480 children with uncomplicated appendicitis. Compared with surgery, nonoperative management had nearly five times higher failure rates and more major complications, with about one in five patients experiencing recurrence within a year. Although antibiotic-treated patients returned to school a few days sooner, this small benefit was offset by frequent readmissions and reinterventions. The takeaway: appendectomy remains the more reliable and durable option.
Dr. Joshua Belfer, MD, is a Pediatric Emergency Medicine physician at the Children’s Hospital of Philadelphia, and is the Founder and Editor-in-Chief of HipPEMcrates. He can be reached at HipPEMcrates@gmail.com.
