Articles: pediatrics.
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Minerva anestesiologica · Nov 2024
Comparison of dexmedetomidine, ketamine, and magnesium sulfate for the prevention of emergence agitation following sevoflurane-based anesthesia in pediatric cardiac catheterization.
Emergence agitation (EA) is non-purposeful agitation that occurs during the early stages of general anesthesia recovery. This randomized, double-blinded trial aimed to compare the effect of dexmedetomidine, ketamine, and magnesium sulfate on the severity of EA following sevoflurane-based anesthesia in pediatric cardiac catheterization. We examined the fixed doses and assessed the severity of agitation using the Pediatric Anesthesia Emergence Delirium Scale (PAED) score. ⋯ Dexmedetomidine exhibited higher efficacy than ketamine and magnesium sulfate in reducing the severity of postoperative EA. However, ketamine and magnesium sulfate demonstrated comparable efficacy, exceeding that of the control group.
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Rathke cleft cysts are congenital, non-neoplastic sellar cysts derived from remnants of embryonic Rathke pouch. Presentation of Rathke cleft cysts can be incidental; however, in larger cysts, presentation can be with headaches, visual deterioration, and pituitary and endocrine dysfunction. Here we report a rare case of identical twin boys with Rathke cleft cysts, highlighting the likely genetically driven development of cyst in this identical twin and need for cranial imaging in identical twins with anomalies of the brain.
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J Pain Symptom Manage · Nov 2024
Pediatric Palliative Care Simulation Improves Resident Learning Outcomes: an 11-Year Review.
Many general pediatrics residents lack sufficient opportunities to conduct difficult conversations with families, particularly about end-of-life care. Simulation learning is an effective means of practicing professional skills. A pediatric palliative care (PPC) physician is uniquely suited to mentor residents and fellows learning to lead difficult conversations through simulation. Co-facilitation of the simulated difficult conversation by a bereaved parent or family member enhances the learning experience. ⋯ Simulations with bereaved parent actors improved general pediatrics residents' performance and comfort during difficult conversations and are transportable to diverse settings.