Using the pain principle to provide a new approach to invasive treatments and end-of-life care

End-of-life issues involving small babies are particularly challenging for doctors, particularly pediatricians as there are complex issues involved, including long-term disabilities (1) and the parents' wishes (1). Evaluations can be based on statistical risks (2) and case-by-case issues. Some authors (3) suggest that intensive care can be withheld when consciousness is compromised, but that raises questions about what level of consciousness equates to a baby being completely compromised (4). Other authors have questioned whether suspending therapies when the baby is not at their end-of-life is ethically right. Concerns have also been expressed that there is a risk that babies lives are undervalued, in comparison with older patients, because their life support is removed more easily than when adults have a similar prognosis

Relating pain intensity of newborns to onset of nonlinear phenomena in cry recordings

The cries of several full term newborns, recorded during blood sampling, were analyzed. Spectrograms showed the appearance of irregular patterns related to the pain assessed using the method of the DAN scale. In particular, the appearance of Noise concentration Patterns (NP) in spectrograms was related to the increase of the pain suffered by the newborns. In this scenario, pain constitutes a bifurcation parameter for the vocal folds dynamic, inducing a Ruelle-Takens-Newhouse chaotic transition.Comment: 15 pages, 4 figures, 1 table. Accepted for publication in Phys. Lett.

Nurses and Doctors Heroes? A Risky Myth of the COVID19 Era

Recent newspapers reports have named health professionals as “heroes”. This is surprising, because in the last few decades, doctors and nurses have been taken into account by mass media only to describe cases of misconduct or of violence. This change was due to the coronavirus pandemic scenario that has produced fear in the population and the need for an alleged “savior”. This need for health professionals seen as heroes is also disclosed by the fact that even politicians have abdicated to their role in favor of the healthcare “experts” to whom important decisions on social life during this pandemic have been delegated, even those decisions that fall outside of the specific health field. This commentary is a claim to framing the job of caregivers in its correct role, neither angel nor devil, but allied to the suffering person, that the image of “heroes” risks to overshadow

The Best Age for Pregnancy and Undue Pressures

In western countries we assist at the paradox that fertility is socially discouraged by a mindset that depicts fertility as a resource to exploit as late as possible. So, couples have high expectative about the advantages of delayed parenthood, but they are scarcely informed about its risks. Scientific data suggests to anticipate the first pregnancy, but social pressures impose to wait, though delayed childbearing can provoke sterility and a greater gap between generations. The best age to become parents should be autonomously decided by a couple, under the condition of being a free informed choice and not a social imposition, but currently this is not guaranteed to western women and men

Analgosedation in neonates: what we know and how we act

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Abortion and subsequent mental health: Review of the literature

The risk that abortion may be correlated with subsequent mental disorders needs a careful assessment, in order to offer women full information when facing a difficult pregnancy. All research papers published between 1995 and 2011, were examined, to retrieve those assessing any correlation between abortion and subsequent mental problems. A total of 36 studies were retrieved, and six of them were excluded for methodological bias. Depression, anxiety disorders (e.g. post-traumatic stress disorder) and substance abuse disorders were the most studied outcome. Abortion versus childbirth: 13 studies showed a clear risk for at least one of the reported mental problems in the abortion group versus childbirth, five papers showed no difference, in particular if women do not consider their experience of fetal loss to be difficult, or if after a fetal reduction the desired fetus survives. Only one paper reported a worse mental outcome for childbearing. Abortion versus unplanned pregnancies ending with childbirth: four studies found a higher risk in the abortion groups and three, no difference. Abortion versus miscarriage: three studies showed a greater risk of mental disorders due to abortion, four found no difference and two found that short-term anxiety and depression were higher in the miscarriage group, while long-term anxiety and depression were present only in the abortion group. In conclusion, fetal loss seems to expose women to a higher risk for mental disorders than childbirth; some studies show that abortion can be considered a more relevant risk factor than miscarriage; more research is needed in this field