The effect of stillbirth and late termination of pregnancy on the emergence of post-traumatic symptoms among attending medical personnel.

The purpose of this paper was to assess the impact and the post-traumatic potential of late termination of pregnancy (TOP) and stillbirth on medical staff and characterise personal attributes that modulate these possible outcomes. Fifty-one participants involved in the treatment of women undergoing late TOPs and stillbirths answered questionnaires including demographics, Neuroticism subscale of the Big Five Inventory (BFI), Life Orientation Test-Revised (LOT-R), Posttraumatic Diagnostic Scale (PDS), Brief Symptom Inventory (BSI-18) and questions regarding exposure to stillbirths and late TOPs. None of the participants met the full post-traumatic stress disorder (PTSD) criteria. A correlation with a marginal significance was found between the number of TOP's/stillbirths attended during the past year and traumatic symptoms. Neuroticism moderated the association between presence in TOP's/stillbirths and post-traumatic symptoms among those who attended this event over the past month. According to our results, medical personnel do not appear to develop long-term and lingering posttraumatic symptoms following attending TOP's/stillbirths. Impact StatementWhat is already known on this subject? There is a very little research on the ways in which medical personnel respond to Stillbirths, late miscarriages and terminations of pregnancy (TOP) of their patients and on the possible effect of their personality traits in this response.What do the results of this study add? According to our results, medical personnel do not appear to develop long-term and lingering posttraumatic symptoms following attending TOP's/stillbirths.What are the implications of these findings for clinical practice and/or further research? Further studies are warranted to better assess the impact of exposure to traumatic events in general and on the effect of late TOP and stillbirths in particular, on medical personnel and to identify interventions that may prevent posttraumatic symptoms among staff members when they happen.

Is there an association between subclinical hypothyroidism and preterm uterine contractions? A prospective observational study.

OBJECTIVE: To investigate the association between subclinical hypothyroidism and preterm contractions. METHODS: Prospective observational study among women at 23 + 0/7 and 34 + 6/7 weeks of gestation, with no known thyroid function abnormality, and preterm uterine contractions (PTC). All patients underwent laboratory evaluation of Thyroid Stimulating Hormone (TSH) and Free Thyroxin (FT4). Patients with and without PTC were compared. RESULTS: No association was found between PTC and subclinical hypothyroidism. Rate of spontaneous preterm delivery (PTD) was comparable between women with abnormal and normal thyroid function tests. Excluding indicated PTD, patients in the study group had a higher rate of spontaneous PTD (24.7% versus 9.6%, p = 0.03). Patients with past PTD and preterm contractions had higher rates of hypothyroxinemia compared with patients without past PTD (54.6% versus 19.0% and 31.2%, p = 0.001), and patients with past PTD (regardless of the presence or absence of PTC) had higher rate of subclinical hypothyroidism compared with patients with PTC and without PTD (59.1% and 66.7% versus 31.6%, p = 0.017). CONCLUSIONS: No association was found between PTC and subclinical hypothyroidism in the entire cohort, except for patients with preterm contractions and a history of past PTD. This specific group of patients might benefit from thyroid function evaluation.

Parotid mass as presenting symptom of lymphoma.

BACKGROUND: Lymphomas arising from the parotid gland are an uncommon entity, said to account for only 0.6-5% of tumors or tumor-like lesions of the parotid, and are therefore commonly overlooked. This misdiagnosis often leads to unnecessary diagnostic procedures, delaying the initiation of proper treatment. OBJECTIVES: To examine the clinical, diagnostic, therapeutic and survival data of patients with this disease. METHODS: We retrospectively reviewed our experience with patients diagnosed and treated for parotid lymphoma in our medical center during the period 1998-2008. RESULTS: The 13 patients in the series were aged 42-83. Twelve had non-Hodgkin's lymphoma and 1 had Hodgkin's lymphoma. In eight, parotid mass was the first manifestation of the disease, while in five who were in clinical remission its reoccurrence was first manifested in the parotid gland. Mean survival was 6.3 years CONCLUSIONS: Since parotid lymphoma is uncommon, it is often overlooked in the differential diagnosis. Methods of diagnosing and treating parotid lymphoma are different from those of other parotid pathologies. A high index of suspicion is warranted in order to provide a quick and efficient diagnosis and treatment without subjecting the patient to unnecessary tests and procedures.