Search

The idea of autonomy has been emphasized in North American bioethics, understood mainly as non- interference in the decision-making of individuals. This "legal" concept of autonomy, which defends self-determination, is insufficient and partial. From a European Mediterranean perspective, autonomy can be understood not only as an exercise of freedom, but also as something that has to do with context, circumstances and relationship with others. For this reason, this paper proposes a vision of a Mediterranean autonomy from three categories: narrative, relational and careful. In this proposal we rely on Paul Ricoeur's re-reading of the concept of autonomy. [ABSTRACT FROM AUTHOR]

The pandemic has placed us in a situation of estrangement from ourselves. We have been acutely aware of our vulnerability and fragility. Through the stories of lived experiences, we have learned about and witnessed tragic circumstances in which inhospitality and neglect have become evident. We have been shocked by the awareness of the lack of recognition, accompaniment and welcome. Institutional decisions have prioritized public health, the good for all, but have forgotten the biographies of people, full of suffering. And this has produced a moral damage, a loss of trust, a feeling of injustice that we have not been able to fight against. This is why it is necessary to build hospitality, which can be achieved through care. Care with a political dimension that takes charge of reality and transforms society. The key is a responsibility in solidarity. Faced with the possibility of dehumanizing ourselves, we seek hospitality as an alternative way of narrating lives that have to be reconstructed, that have to relearn how to take care of each other amidst the multiple possibilities of estrangement that threaten us. Hospitality is at the heart of a narrative ethics at the height of our times., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Introduction: Congenital heart disease (CHD) is one of the most frequent congenital diseases. When expectant fathers and mothers are informed of a CHD during pregnancy, they have to confront a series of individual and interpersonal psychological changes. The aim of the study was to evaluate the psychological impact of a prenatal diagnosis of CHD on expectant parents. The sample included 214 participants, mothers and their partners (case group, 57 pregnant women carrying a foetus with CHD and their partners and control group, 50 pregnant women and their partners)., Method: Administration of the BSI-18, the DAS and FACES-III following prenatal diagnosis., Results: Many parents (approximately 83.6%) went through stages of shock and denial in response to the diagnosis of disease that they had to confront and accept. At the individual level, 35.1% of fathers and 47.4% mothers had clinically significant scores of psychological distress. At the couple level, both fathers (77%) and mothers (82.4%) had expressed an idealized dyadic adjustment. Lastly, the perception of the family dynamic by 43.9% of fathers and 42.2% of mothers was in the mid range., Conclusion: The results highlight the complexity of the initial stage that these couples were going through., (Copyright © 2021 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.)

Introduction: Congenital heart disease (CHD) is one of the most frequent congenital diseases. When expectant fathers and mothers are informed of a CHD during pregnancy, they have to confront a series of individual and interpersonal psychological changes. The aim of the study was to evaluate the psychological impact of a prenatal diagnosis of CHD on expectant parents. The sample included 214 participants, mothers and their partners (case group, 57 pregnant women carrying a foetus with CHD and their partners; and control group, 50 pregnant women and their partners)., Method: Administration of BSI-18, DAS and FACES-III following prenatal diagnosis., Results: Many parents (approximately 83.6%) went through stages of shock and denial in response to the diagnosis of disease that they had to confront and accept. At the individual level, 35.1% of fathers and 47.4% mothers had clinically significant scores of psychological distress. At the couple level, both fathers (77%) and mothers (82.4%) had expressed an idealized dyadic adjustment. Lastly, the perception of the family dynamic by 43.9% of fathers and 42.2% of mothers was in the mid-range., Conclusion: The results highlight the complexity of the initial stage that these couples were going through., (Copyright © 2021 Asociación Española de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.)

Omental cysts are uncommon benign masses localized in the abdomen. This article describes the case of a male infant who underwent surgery due to a left inguinal hernia. During the operation a small omental cyst was found inside the sac that was resected. The first postoperative days were uneventful but the infant came back to hospital seven days after. Subsequent imaging and operative findings revealed a complicated omental cyst. This cyst was removed and the histopathology report described an inflammatory pseudotumor. The postoperative evolution was satisfactory and the patient has remained asymptomatic since he was discharged from hospital. In conclusion, it is important to explore the contents of the hernial sac during inguinal hernia repair. The finding of a small omental cyst inside the sac should encourage to study other potential intraabdominal lesions.

PURPOSE. To submit the short and long term results of long-gap esophageal atresia (EA) with two surgical techniques. METHODS. We carried out a retrospective study of long-gap type EA without fistula (n=8) and with fistula (n=2) over the last 18 years, comparing the outcome of the Schärli technique (1992) with that of the Foker technique (1997). RESULTS. We included 10 patients with long gap EA. Mean birth weight was 2,418 grams. 30% had associated diseases (VACTERL, Down Syndrome, DiGeorge Syndrome). Gastrostomy or jejunostomy was initially placed in 7 patients. Schärli technique was performed in 4 patients (mean age: 3.3 months), and Foker technique in 6 patients (median age: 23.5 days of life). Complications were: a) Schärli: dehiscence (25%), stenosis (75%), one patient died from his heart disease (25%), colonic herniation through diaphragmatic hiatus (25%). The mean number of stricture dilatations was 7 sessions (S.D. 9.2). a) Foker: dehiscence (83.3%), stenosis (83.3%), gastroesophageal reflux (GER) (83.3%), fistula (16.7%). Mean number of dilatations was 13.7 sessions (S.D. 12.8). All patients operated on with Schärli technique (6-18 years, median follow-up 12 years) were asymptomatic at the time of the study, although one of them had grade III esophagitis in the last biopsy. As for the Foker's, 5 had undergone antireflux surgery and only one was asymptomatic. The rest had complications that were still being treated (stenosis and development of fistulae). CONCLUSION. Treatment of long gap EA remains a surgical challenge. In our experience patients developed fewer complications with the Schärli technique. Nevertheless, it is difficult to make a comparison with such a limited number of patients.