Analysis of Pre-procedural Intranasal Anxiolytic Use in the Emergency Treatment of Pediatric Laceration Repair

Pediatric laceration repair is a common, yet anxiety-inducing procedure for patients who must undergo them, with limited research analyzing the different types of pre-procedural anxiolytic medications. The purpose of this research and literature review was to analyze two different, but commonly used intranasal anxiolytics, dexmedetomidine and midazolam, and to compare the efficacy, adverse effects, and overall pediatric anxiety and parental satisfaction. Only articles including clinical trials and pediatric participants were included. A combination of keywords and MeSH phrases included, but were not limited to “pediatric”, “laceration repair”, “anxiolytic”, “administration intranasal”, “intranasal midazolam”, “intranasal dexmedetomidine”, and “parent satisfaction” were used to find relevant articles for each theme. Meta-analyses, animal studies, dental procedures, imaging procedures, full sedation procedures, and ongoing studies were excluded. In terms of effective anxiolysis, intranasal dexmedetomidine at a 2 or 3 ug/kg dose should be considered the preferred intranasal medication for pediatric laceration repair procedures as it significantly reduced anxiety levels during laceration repair and increased parental satisfaction scores without having any reported significant adverse effects. Counteractively, intranasal midazolam, when administered at a dose of 0.4 mg/kg 5mg/mL solution also revealed a decrease in pediatric anxiety, but also imposed vomiting adverse effects. Therefore, intranasal dexmedetomidine (IND) is preferred. Future studies regarding IND’s bioavailability, pharmacokinetics, and optimal doses per age or weight groups could be considered in the future for further supportive evidence

Improving Fertility in Women with Endometriosis

Endometriosis is a common condition in women and has a strong association with infertility. The purpose of this literature review is to determine the efficacy of hormonal therapy as compared to surgical therapy before assisted reproductive therapy (ART) on endometriosis-related infertility. The electronic databases PubMed and Embase were searched from June 23, 2024, to January 4, 2025. Keywords used were associated with fertility, IVF, and endometriosis. Article selection was limited to research published after the year 2000 with a preference for randomized control trials (RCTs), although one pilot study and one clinical cohort study were also included. The search yielded 59 total articles. Exclusion criteria included lack of hard fertility endpoints including pregnancy rate or live birthrate, and any therapies that did not include either surgery or hormonal therapy in conjunction with ART. A total of seven articles were included in this review. Reviewed literature indicates that prior to ART, both surgical cystectomy and prolonged gonadotropin releasing hormone (GnRH) downregulation improves fertility outcomes in women with endometriosis. However, to date there are no published studies that directly compared the effects of hormonal therapy to surgical therapy on fertility in women with endometriosis, and future research should be conducted to determine and compare those effects to guide clinical decision making for women experiencing infertility secondary to endometriosis

Vern

Vernon Olson poses in front of a grass hut in the hot Fijian heat. Title taken from photographer\u27s original album.https://commons.und.edu/infantry-photos/1155/thumbnail.jp

A Bit of Poker

A circle of unidentified men play a round of poker. Title taken from photographer\u27s original album.https://commons.und.edu/infantry-photos/1134/thumbnail.jp

Crocodile Found

Troops circle around a crocodile they had found.https://commons.und.edu/infantry-photos/1137/thumbnail.jp

Salla

Woman named Salla leans against a tree, smiling away from the camera. Title taken from photographer\u27s original album.https://commons.und.edu/infantry-photos/1148/thumbnail.jp

Royal Winnipeg Ballet - Nutcracker

Cast members of Royal Winnipeg Ballet Nutcrackerhttps://commons.und.edu/performing-arts-photos/1111/thumbnail.jp

Fiddler on the Roof

Cast of Fiddler on the Roofhttps://commons.und.edu/performing-arts-photos/1083/thumbnail.jp

Charlie Pride

Charlie Pride at the Chester Fritz Performing Arts Centerhttps://commons.und.edu/performing-arts-photos/1052/thumbnail.jp

Golden Grain Biscuit Co.

Undated photograph of a photo of the Golden Grain Biscuit Co.https://commons.und.edu/gf-city-photos/1195/thumbnail.jp