Venepuncture for blood sampling can be a distressing experience for a considerable number of children. A prospective controlled trial was conducted to compare the efficacy of a local anaesthetic (EMLA) with a combination of EMLA with self-hypnosis in the relief of venepuncture-induced pain and anxiety in 45 paediatric cancer outpatients (age 6-16years). A secondary aim of the trial was to test whether the intervention will have a beneficial effect on parents' anxiety levels during their child's procedure. Patients were randomized to one of three groups: local anaesthetic, local anaesthetic plus hypnosis, and local anaesthetic plus attention. Results confirmed that patients in the local anaesthetic plus hypnosis group reported less anticipatory anxiety, and less procedure-related pain and anxiety, and were rated as demonstrating less behavioural distress during the procedure than patients in the other two groups. Parents whose children were randomized to the local anaesthetic plus hypnosis condition experienced less anxiety during their child's procedure than parents whose children had been randomized to the other two conditions. The therapeutic benefit of the brief hypnotic intervention was maintained in the follow-up. The present findings are particularly important in that this study was a randomized, controlled trial conducted in a naturalistic medical setting. In this context, convergence of subjective and objective outcomes was reached with large effect sizes that were consistently supportive of the beneficial effects of self-hypnosis, an intervention that can be easily taught to children, is noninvasive and poses minimal risk to young patients and their parents.

Pain. 2009 Apr;142(3):255-63. Epub 2009 Feb 23. Liossi C, White P, Hatira P. School of Psychology, University of Southampton, Highfield, Southampton S017 1BJ, UK. cliossi@soton.ac.uk

The more important clinical manifestations and the opportunities of screening of Down syndrome are shortly summerized in this paper. The methods used for screening (biochemical markers, fetal ultrasound signs) and the most important screening tests (combined screening, integrated screening) are shown. Afterwards the author analyses the situation of screening in Hungary, and he underlines that the maternal age over 35 years, as well as the lower level of alfa-fetoprotein in the serum cannot be the only indication of amniocentesis. The first aim should be to increase the detection rate of disease diagnostics and to decrease the number of amniocenteses. Nowadays the most effective screening method is the combined test in the first trimester. The nationwide introduction of this method requires the improvement of personal and material environment of ultrasound diagnostics and the corresponding financial background.

Orv Hetil. 2009 Mar 15;150(11):497-502. Gardó S. Petz Aladár Megyei Oktató Kórház Szülészeti és Nogyógyászati Osztály Gyor Pf. 92. 9002.