Highlights in this issue

Abstract

Neonates in intensive care units experience a number of painful procedures each day. It not only disturbs the homeostatic physiological balance but also causes subjective suffering, since we now know that pain is processed at the cortical (conscious) level. In this issue (pp. 932–939), Paola Lago and an Italian panel of neonatologists publish guidelines for procedural pains in the newborn. Analgetic drugs as well as non-pharmacological pain strategies are extensively reviewed. See also article by Anna Ullenhag et al., who report that infants who were cared for in a flexed position in a nest (NIDCAP) showed a higher level of motor development in arms/hand and trunk at four month of age (pp. 947–952). The risk of being born small for gestational age (SGA) is not only related to maternal health but also to health of the grandmothers. If the grandmothers have a history of cardiovascular disease, there is an increased risk of being born SGA. This interesting finding is based on a register study of 1.4 million women and 2.7 million offspring. It strongly supports the fetal programming hypothesis and indicates the existence of genetic traits or influence of life-style habits crossing generations. This is reported by Peter Nilsson et al. (pp. 985–989). The brain does not grow as well outside the womb as inside, particularly if the infant suffers from respiratory problems and/or infections. Tuula Kaukola et al. speculate that perinatal events disrupt the programming of cortical development, synapse formation and integrity of the sub-plate zone (pp. 990–995). See also article by Zoltan Nagy and Baldvin Jónsson showing structural brain abnormalities in adolescents born preterm (pp. 996–1001). Bullying is a more common problem among ex-premies. Bullying is a worldwide problem ranging between 9–54% among school pupils. Adolescents who were born with very low birth weight seem to be special victims. This may be due to disturbed connectivity in white matter tracts leading to attention deficit and poor motor skills and social cognition. Poor basal skills, low popularity and status in the peer group may also contribute. See report by Anna Sorte Grindvik et al. (pp. 1049–1056). The understanding of innate or acquired immunity in the role of a humoral versus cell mediated immunity was a historical landmark of immense importance for paediatrics. In 1908, Paul Ehrlich from Germany and Ilya Mechnikov from Ukraine, were awarded the Nobel Prize. This fascinating discovery and also the interesting biographies of the discoverers are described by Rolf Zetterström (pp. 1066–1069).