The Psychological Impact of the COVID-19 Outbreak on Pregnancy and Mother-infant Prenatal Bonding

This study aimed to assess the impact of the COVID-19 stress and anxiety on prenatal attachment during the second trimester of gestation. Pregnancy is an important stage for mothers-to-be in creating representations of themselves as a “mother”, with the developing attachment relationship to the unborn child considered as a milestone in the future parent’s developmental trajectory. The outbreak of the COVID-19 pandemic and the national health measures installed can hence have consequences on these representations and on prenatal attachment. Our sample consisted of 95 mothers that were recruited from a prenatal ultrasound screening center. Results suggested that the COVID-19 pandemic significantly affected prenatal attachment (PAI) with significant correlations between PAI total score and age, anxiety (DASS) and stress (IES-R). When entered in one model looking for predictors of PAI total score, age and COVID-19 stress were the only variables found to significantly predict prenatal attachment. We argue for a cultural component in explaining these results, hypothesizing that stress could trigger defensive strategies, leading to more investment in the attachment relationship, potentially playing the role of a protective factor.

The Fibromyalgia Bladder Index in 100 consecutive women with fibromyalgia

INTRODUCTION AND HYPOTHESIS

The Fibromyalgia Bladder Index (FBI) is a validated instrument to quantify bothersome bladder symptoms specifically in women with fibromyalgia syndrome (FMS). The FBI includes two sub-scales: one addressing urinary urgency and bladder pain (UP), the other addressing urinary frequency and nocturia (FN). The objectives of this study are to evaluate the FBI in a cohort of patients with FMS, to correlate it with certain characteristics in this cohort, and to compare it with controls.

METHODS

We performed a case-control study of 100 women with FMS and 155 controls. Demographic data, comorbidities, and other characteristics were registered. Comparison between FBI scores of participants with and without FMS, as well as correlation of FBI scores with the characteristics of FMS patients, were undertaken using independent two-sample t test for continuous outcomes and Pearson's Chi-squared test for categorical outcomes.

RESULTS

The mean UP subscale score of the FBI was significantly higher in the FMS group (10.29 ± 5.61) compared with the controls (1.65 ± 2.65; (p = 0.001). The mean FN subscale score was significantly higher in the FMS group (9.93 ± 5.37) compared with the controls (2.95 ± 3.27; p = 0.001). FMS patients diagnosed >3 years ago had a higher UP subscale score and a higher FN subscale score compared with FMS patients diagnosed <3 years ago (p = 0.020 and p = 0.024 respectively). Menopause and parity significantly increased the FBI scores. Smoking and a history of depression did not significantly affect any of the FBI subscale scores in the FMS group.

CONCLUSION

Women with FMS suffer from bothersome bladder symptoms that can be readily identified and quantified.

Cupping in dermatology: a critical review and update

Cupping is an ancient procedure that has been practiced for thousands of years. It has been used to treat a variety of medical conditions, including dermatological ones. Cupping has been described in the literature for the treatment of conditions such as acne and eczema. The procedure is fundamentally divided into dry cupping and wet cupping; however, there have been many modern adaptations. Adverse events related to the procedure have been reported in the literature and should be considered by patients. However, cupping has a promising role in helping manage dermatological conditions.

Squamous cell carcinoma of the skin: epidemiology, classification, management, and novel trends

Squamous cell carcinoma (SCC) is the second most common non-melanoma skin cancer. It originates from epidermal keratinocytes or adnexal structures (such as eccrine glands or pilosebaceous units). We describe the salient features of cutaneous SCC. We also review novel classification schemes proposed during the last decade which attempt to stratify SCC lesions based on prognosis. Biopsy leads to definitive diagnosis. Treatment includes surgical excision; Mohs micrographic surgery produces excellent cure rates and spares the maximal amount of tissue. Other modalities include electrodessication and curettage, cryosurgery, radiotherapy, topical medications, photodynamic therapy, and systemic therapy. Management and follow-up depend on the risk stratification of individual lesions.

Radiological signs of a left atrial aneurysm

We report a case of an acquired mid-sized extrapericardial aneurysm in the area of the left atrial appendage and demonstrate the diagnostic impact of several imaging methods. Chest radiography gave a hint to the diagnosis with a bulky mass of soft tissue density appearing adjacent to the left atrial appendage. Transthoracic as well as transesophageal echocardiography missed the origin of the aneurysm. Magnetic resonance imaging helped to establish the diagnosis with use of a coronal imaging plane. No contrast agent was necessary. Thus, the combination of chest X-ray and MRI provided excellent support for patient management.

[Systemic diseases and blastomas of the foot]

Analysis of roentgenograms by location, pattern of destruction, classification of tumor matrix and periosteal new bone formation, together with clinical data, preserves valuable information for discrimination of neoplasms in the foot. Furthermore, specific information on tumor histology and tumor extension in the bone marrow and soft tissues can be obtained by CT and MRI. Preoperative staging, guided biopsy of tumor tissue, monitoring of chemotherapeutic response and postoperative observation are further indications for MRT and other modern imaging modalities.