ABSTRACT
Solitary fibrous pleura tumor is a rare primary intrathoracic tumor of the pleura. It usually has an indolent clinical course, but sometimes it can have an aggressive behaviour. In 1930 Doege and Potter independently described this neoplasm, presenting with symptoms of hypoglycemia, hence the eponim of Doege-Potter's Syndrome. In this report, we illustrate a case of Doege Potter's Syndrome, treated with complete surgical resection.
Subject(s)
Hypoglycemia/etiology , Solitary Fibrous Tumor, Pleural/complications , Aged , Humans , Male , Severity of Illness Index , Solitary Fibrous Tumor, Pleural/pathology , Solitary Fibrous Tumor, Pleural/surgery , SyndromeABSTRACT
OBJECTIVE: In this study anxiety and depressive disorders were evaluated in patients admitted to an emergency department (ED) or to a medical department (MD). METHODS: The General Health Questionnaire-30 (GHQ-30) was administered to screen all patients (n = 719) consecutively admitted to an ED (n = 556) and to MD (n = 163) in a 120 day period. All GHQ-30 positive (score>4) underwent the Mini International Neuropsychiatric Interview, a structured interview to diagnose mental disorders according to DSM-IV criteria. RESULTS: Subjects positive to GHQ-30 were 264 (47%) in ED and 88 (54%) in MD. A mental disorder was diagnosed in 233 ED patients (42%) and in 77 MD patients (47%) (p = 0.70). The most frequent disorders were anxiety disorders in ED patients (18.1%) and depressive disorders in MD patients (21%) (p = 0.04). CONCLUSIONS: Anxious patients more frequently seek attention at ED, whereas patients with depressive disorders are more often observed in medical units. The improvement of quality of care, the waste of healthcare resources through unnecessary medical care, and the well known efficacy of appropriate treatments in patients with anxiety and depressive disorders make the diagnosis of these patients particularly important.
Subject(s)
Anxiety Disorders/diagnosis , Depressive Disorder/diagnosis , Adult , Anxiety Disorders/complications , Anxiety Disorders/psychology , Depressive Disorder/complications , Depressive Disorder/psychology , Emergencies , Female , Hospitalization , Hospitals, General , Humans , Male , Middle Aged , Psychiatric Status Rating Scales , Sex Factors , Socioeconomic Factors , Surveys and QuestionnairesABSTRACT
OBJECTIVE: The present study examined patients during the year after the index hospitalization in an Emergency Ward (ED) to determine whether patients with depressive or anxiety disorders have a higher rate of readmission than patients without these conditions. METHOD: For this purpose, 165 subjects (85 diagnosed with DSM-IV depressive or anxiety disorders and 80 controls) were evaluated with the Hospital Anxiety and Depression Scale (HADS) and with the Duke Severity of Illness Scale both during the index hospitalization and one year later. Hospitalizations during the follow-up period were determined using the hospital database. RESULTS: During the follow-up period, depressed and anxious patients were more frequently rehospitalized in ED wards than controls (p = 0.006), after controlling for the effect of medical illnesses severity, marital status, living arrangement, and employment status. No difference was found regarding the admissions to wards different from ED. CONCLUSIONS: Patients with depressive or anxiety disorders use the ED ward more frequently than controls for the diagnosis and treatment of somatic symptoms.
Subject(s)
Anxiety Disorders/epidemiology , Anxiety Disorders/rehabilitation , Depressive Disorder, Major/epidemiology , Depressive Disorder, Major/rehabilitation , Emergency Services, Psychiatric/statistics & numerical data , Adolescent , Adult , Aged , Anxiety Disorders/diagnosis , Depressive Disorder, Major/diagnosis , Female , Follow-Up Studies , Hospitalization , Humans , Incidence , Male , Middle Aged , Patient Readmission/statistics & numerical data , Psychiatric Status Rating Scales , Severity of Illness IndexABSTRACT
It is generally accepted that calcitonin (CT) induces a decrement in cytosolic Ca++, and an increase of cAMP in target cells of several organs and tissues. This happens particularly in bone, where osteoclast activity and size decreases, along with the widely-known hypocalcaemic and hypophosphoraemic effect of the hormone. The physiological role of CT appears to be of importance in pregnancy and perhaps in infancy, when it antagonizes possible excessive bone loss. Some experimental evidence shows that CT may be involved in the maintenance of post-meal calcaemia. It is not yet established whether paucity of CT plays any important role in the pathogenesis of pathological conditions such as post-menopausal and senile osteoporosis.
Subject(s)
Calcitonin/physiology , Adult , Age Factors , Aged , Calcitonin/blood , Calcitonin/metabolism , Disease/physiopathology , Female , Humans , Male , Middle Aged , Sex FactorsABSTRACT
Renal tolerability of a guided incremental dose schedule of sulphinpyrazone was evaluated in an open study of 2-month duration, performed in twenty-one cardiovascular elderly azotemic patients (thirteen males, eight females; mean age: 79 years, S.D.: 7 X 3 years). Starting dosage was 200 mg per day; daily dosage was then increased, every 4 days, by 200 mg or kept constant for another 4 days, according to each patient's basal renal function, up to the maintenance dose: 800 mg/day. Eighty-one per cent of the patients followed a successful incremental pathway, 9% kept a constant daily dosage of 200 mg for 8 days, reaching then the maintenance daily dose without any problems. Nine per cent withdrew at 200 mg/day because renal function deteriorated at two consecutive visits. Renal function of the patients who completed the study significantly improved (two-way ANOVA, p less than 0.01). General tolerability was good. The proposed incremental dose schedule of sulphinpyrazone can be successfully used in the treatment of cardiovascular elderly azotemic patients.
