Initial Impact of Perinatal Loss on Mothers and Their Partners.

(1) Background: Perinatal Loss affects one in ten women worldwide. It is known to have a deep impact on the physical and psychological wellbeing of the mother. Moreover, there is a lack of information in regard to gender differences. The role of culture, environment, personal characteristics, and gender is yet to be determined in most reports; (2) Objective and Methods: Our aim is to study the initial impact of perinatal losses in an unselected sample of couples, focusing on gender differences. We conducted a longitudinal prospective study with 29 mothers and 17 fathers. Upon discharge from the hospital, they filled out the Edinburgh Postnatal Depression Scale (EPDS), among others. After one-month post-loss, they performed the EPDS and the Short Version of the Perinatal Grief Scale. We used descriptive statistics for the sample and non-parametric tests for the comparison of gender; (3) Results: We found no gender differences in initial depressive symptoms, nor in depressive symptoms, perinatal grief symptoms, or grief level (total scores or complicated grief) one month after the loss; (4) Conclusions: we need to better understand the psychological evolution of couples in cases of perinatal loss without falling into preconceived ideas about the influence of gender.

Epidemiological study of alendronate-related osteonecrosis of the jaw in the southeast of Scotland.

We aimed to establish the incidence of alendronate-related osteonecrosis of the jaw (ONJ) in the southeast of Scotland, and to assess the effect of corticosteroids on it. We studied a prospective case series of patients between June 2004 and March 2012 separated into steroid and non-steroid groups. There were 34 cases of alendronate-related ONJ and 78732 drug patient years (DPY) of alendronate, making the overall occurrence 43.1 cases/100000 DPY. There were 12 patients in the steroid group (mean (range) age 68.2 (48-87) years) making 42.5 cases/100000 DPY, and 22 in the non-steroid group (mean (range) age 76.2 (63-91) years) making 119.6 cases/100000 DPY. The mean (range) age at presentation of alendronate-related ONJ was significantly lower in the steroid group (68.2 (48-87) compared with 76.2 (63-91) years, p=0.019) as was the duration of exposure to alendronate before it developed (28.9 (6-120) compared with 61.3 (13-168) months, p=0.03). The overall incidence seems to be higher in the southeast of Scotland than elsewhere. Concurrent use of corticosteroids is not associated with an increased incidence of alendronate-related ONJ, but it seems to reduce the duration of exposure before it develops. Age is likely to be a confounding factor.

Influence of cognition, premorbid adjustment and psychotic symptoms on psycho-social functioning in first-episode psychosis.

OBJECTIVE: The aim of this study is to evaluate the relationship between psycho-social functioning and symptoms, cognitive function, and premorbid adjustment, in patients with a first-episode psychosis. METHOD: Clinical data were obtained from 90 patients, who were assessed with the Disability Assessment Scale (DAS-sv), the Positive and Negative Syndrome Scale (PANSS), the Premorbid Adjustment Scale (PAS-S) and with a battery of cognitive tests including Trail Making Tests A and B (TMTA- B), Continous Performance Test (CPT), some subscales of the Wechler Adult Intelligence Scale (WAIS), and the Verbal Learning Test España-Complutense (TAVEC). RESULTS: The results of the study suggest that psycho-social functioning in first-episode psychosis is significantly related to: positive, negative, excitative, affective and disorganized symptoms, social premorbid adjustment, cognitive flexibility, working memory, short term and long term memory. Of these, those which best explained psycho-social functioning are the positive and excitative symptoms, premorbid adjustment, flexibility and memory. CONCLUSIONS: These findings highlight the importance early intervention on cognitive and clinical variables to help provide a better psycho-social functioning in people with a first-episode of psychosis.

Non-complex reconstructive techniques in the management of BRONJ: a case series of patient-related outcomes.

OBJECTIVES: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a well-recognised condition that continues to be a therapeutic challenge. It can have devastating effects on patients' quality of life. The literature recommends a myriad of management strategies. This case series demonstrates a combination of resection procedures, local reconstruction options and their impact on quality of life. PATIENTS AND METHODS: This case series consisted of three patients with BRONJ following the use of bisphosphonates (BPs); for metastatic and metabolic bone diseases, none responded to conservative treatment. All patients were surgically managed by a standardised protocol combining bone resection and local reconstructive measures. RESULTS: We evaluated surgery-related change in quality of life using the "University of Washington Quality of Life Questionnaire". At 3 months, all patients were pain free but were only able to manage soft foods and one persisted in using a straw for fluids. In all cases, quality of life scores showed an overall improvement or remained unchanged. There was no evidence of BRONJ recurrence. CONCLUSION: Quality of life is an important consideration in the management of BRONJ patients. Optimal surgical resection and reconstruction may be an ideal treatment plan, but in medically compromised patients, this may not be possible. Consideration should be given to modified strategies with a potentially lower morbidity, yet still aiming to improve patients' quality of life.

Necrotising sialometaplasia in the floor of mouth.

INTRODUCTION: Necrotising sialometaplasia is a benign self-limiting inflammatory process which occurs in the salivary gland tissue. The condition is a diagnostic challenge mimicking malignancy both clinically and histopathologically. Commonly, it presents in the hard palate. CASE REPORT: Here, we report an unusual case in a 56-year-old man which presented in the floor of the mouth.

Impacto pronóstico del posparto en una muestra de pacientes ingresadas en la unidad madre-bebé de Burdeos (Francia) / Impact of pregnancy in a sample of patients admitted to the mother and baby unit of Bordeaux (France)

La maternidad es experimentada por un número creciente de pacientes con trastornos psicóticos y afectivos. Nuestro objetivo fue evaluar el impacto pronóstico de este acontecimiento en esta población de pacientes. Realizamos primero una revisión bibliográfica sobre el tema y luego un estudio clínico a partir de una muestra de 49 pacientes ingresadas en posparto (PP) en la unidad madre-bebé (UMB) de Burdeos. Los datos de la literatura médica sobre las repercusiones del embarazo son generalmente divergentes, lo que sugiere que éstas son variables e imprevisibles. Sin embargo, el PP se asocia a un aumento importante del riesgo de descompensación aguda en las pacientes con trastornos afectivos. Varios estudios de seguimiento de cohortes de pacientes que presentaron un episodio psicótico en el PP han permitido no considerar estos episodios como entidades independientes y específicas del PP, sino como episodios inscritos en el curso de un trastorno, más frecuentemente el bipolar. Los resultados de nuestro estudio concordaron con estas conclusiones. Respecto al impacto de la maternidad a largo plazo, la literatura médica destaca las dificultades específicas que presentan las pacientes con trastornos psicóticos y afectivos en su función parental, pero resulta bastante difícil evaluar sus repercusiones en la evolución de los trastornos. Los datos de la literatura científica, así como los resultados de nuestro estudio, muestran efectivamente que estas pacientes, al tener hijos, suelen necesitar más atención y cuidados psiquiátricos, sin que esto siempre esté relacionado con un empeoramiento de sus trastornos

An increasing number of patients with psychotic and bipolar disorders have children and are involved in childcare. We aimed to evaluate the impact of maternity on the prognosis of these disorders, through a review of the literature and subsequently by using the results of a follow-up study of 49 patients hospitalized in the postpartum period in the mother and baby unit of Bordeaux. Data in the literature on the effects of pregnancy on the mental health of patients with psychotic and bipolar disorders are heterogeneous, suggesting that the repercussions are varied and unpredictable. The postpartum period, however, is associated with a high risk of acute breakdown in patients with bipolar and schizoaffective disorders. Follow-up studies of patients with a history of postpartum psychotic episodes have indicated that these episodes should not be considered as independent entities specific to the postpartum period but rather as episodes occurring within the course of an existing disorder, usually bipolar disorder. The results of our study agree with these conclusions. The literature on the long-term impact of maternity on the mental health of patients with psychotic and bipolar disorders stresses specific parenting difficulties in this population. However, evaluating the repercussions of maternity on the course of these disorders is difficult. Both data in the literature and the results of the present study show that patients who became mothers need more psychiatric care, but that this does not always reflect an aggravation of their disorders