Highlights in this issue

Abstract

Hearing loss can be detected in the newborn period either by photoacoustic emission (OAE) or by automated auditory brainstem response (AABR). AABR is superior to OAE as it also detects hearing loss of retrocochlear origin. Two-staged AABR screening was implemented in seven of the ten NICUs in the Netherlands. Infants who did not pass the first stage were tested a second time. Prevalence rate of hearing loss in NICU graduates was found to be 2.2%. This is reported by Paula van Dommelen et al., pp. 1097–1103. See also article by Ze D Jiang et al.; Brainstem auditory response findings in late preterm infants in neonatal intensive care units (published online only pp. e51–e54). Anxiety disorders are the most frequent mental health problems in children and adolescents with prevalence rates ranging from 4 to 25%. Martin Pinquart and Yuhui Shen have now performed a meta-analysis integrating results from 332 studies. Children with chronic fatigue syndrome, migraine/tension headache, sensory impairment and epilepsia were found to suffer most from anxiety. No significant elevations were found for children with arthritis, cancer, cleft lip, cystic fibrosis and diabetes. Even children with cancer and HIV infection did not suffer from anxiety more than children without any chronic disease. See also commentary by Göran Högberg, pp. 1066–1068. Parents can require life-supporting treatments even for children with futile diagnoses. William Meadow and John Lantos now propose an ambiguous approach by the doctor, not based on bioethics or law but instead from literature, poetry and theology. The ambivalent situation, when faced with a tragic choice, is better described by Dostoevsky, Camus and Oe than in textbooks of bioethics. The doctors can say to the parents: «We will do everything we can that we think will help – and we will always be here for you and your child» but then just provide appropriate intervention. Dr William Meadow is going to succeed Dr Alan Leviton as editor of the A Different View section. The editorial board thank Dr Leviton for his excellent editorship. A number of clinical practices have not been scientifically evaluated, and it takes too long a time to abandon them, for example putting children with upper airway infections in horizontal position in bed. Another is to resuscitate newborns with oxygen. In this issue, pp. 1058–1062, Ola D. Saugstad presents new guidelines for newborn resuscitation, which states that ‘it is best to start with air’ instead of oxygen. The recommendation was taken by the 2010 International Liaison Committee on Resuscitation. The recommendations were based on the seminal experimental and clinical studies particularly by OD Saugstad, showing that inhaling oxygen can cause more harm than good in the newborn. See also article by Sarah Sykes et al., pp. 1087–1091. Immediate newborn care practices were assessed after a deadly nosocomial outbreak in a Philippine hospital. The authors found that interventions that protect newborns against infection-related mortality like drying, skin-to-skin contact, breastfeeding initiation and delayed bathing were not carried out. On the other hand, unnecessary suction was performed. Howard L Sobel et al. conclude that the immediate newborn care intervention is below WHO standards (pp. 1127–1133).