Effectiveness and safety of hypnotic drugs in the treatment of insomnia in over 70-year old people.

Good sleep is an important index of the quality of life in people and above all in old subjects. Among all the symptoms reported to general practitioner, insomnia is at the 3(rd) place and this is present in particular in the elderly. In elderly people high comorbidity and polytreatment are often present. We have studied 60 elderly people with history of insomnia and concomitant diseases: depression, dementia and behavioral disturbances. All the patients of the present study were visited in our outpatients' department. Three hypnotic drugs were used for the treatment of insomnia: zolpidem, or triazolam, or oxazepam, respectively at doses of 10mg/day, 0.125-0.25mg/day and 15.0mg/day. All the three drugs showed to be effective and safe; no paradoxical effects were observed.

[Unexpected diagnosis of thorotrast-induced cirrhosis]. / Una inattesa diagnosi di cirrosi da Thorotrast.

It is presented the clinical case of a 73 year old man admitted to hospital with dyspnea and productive cough. Clinico-instrumental investigations demonstrated monolateral pleural effusion and ascites in a severe cirrhotic chronic liver failure. After evacuation of the pleural and peritoneal effusion, chest radiography showed the presence of a double accumulation of radiopaque material in left cervical region and in left paramediastinic site. Chest and abdominal CT scan showed a systemic accumulation of this material in liver, spleen and glands. The characteristics of the iperreflecting substance accumulated were compatible with that of Thorotrast. In the mean time, a prostate cancer with skeletal metastases was diagnosed. Despite therapy, the chronic liver failure causes a rapid deterioration of clinical conditions, with irreversible hepatic coma and death.