Longitudinal evaluation of psychological distress in medical geriatric in-patients.

A longitudinal evaluation of the degree and type of psychological distress was carried out in 50 geriatric medical in-patients, using the Symptom Distress Checklist. They were tested within three days of admission, after 12-15 days of hospital stay, and 20-30 days after discharge. The first two evaluations showed significantly higher distress than the third for almost all the subscales. Scores indicating a significant depressive distress decreased from 70 per cent (first evaluation) and 76 per cent (second evaluation) to 34 per cent at the third one. The number of patients with significant distress for the other SCL-90 subscales was, at the third evaluation, rather low. Our data hence seem to show that the phenomenon of psychological distress in the hospital setting is transitory, and mainly arises from the factors of 'disease' and 'hospitalization'. However, in the case of some particular aspects of psychological distress, such as depression, whilst most patients overcome it, one out of three still presents a significant degree of suffering after returning home.

[Non-secreting malignant tumors of the adrenal cortex. Description of a case]. / I tumori maligni non secernenti del corticosurrene. Descrizione di un caso.

Non-secreting carcinoma of the suprarenal cortex is a rare from of neoplasia. A personal case, characterized by its large dimension (24 cm longitudinal diameter) is reported. Stress is laid on the need for early diagnosis although this is possible only in a limited number of patients owing to the disease's course. Only patients owing to the disease's course. Only early diagnosis, however, can enable the tumour to be removed before metastasis sets in. The malignity of these types is also pointed out, few patients surviving for longer than 5 years.

Chronobiological pattern of growth hormone secretion in normal subjects and in retinopathic diabetics. Lack of suppression by a plurichronocorticoid drug.

Nyctohemeral variations in plasma concentrations of HGH, glucose, and FFA were studied in 22 normal subjects and 48 diabetic patients affected with retinopathy. In the normal subjects, (fourteen males and eight females, mean age 40+/-3 years; body weight less than 110% of I.B.W.) the determinations were made on blood samples drawn every hour. Seven of these normal subjects were examined before and after 10 days of administration of a new plurichronocorticoid drug (administered at 08(00) and 15(00), with a total amount of 14 mg of prednisolone and 15 mg of cortisone). In patients with diabetic retinopathy (32 male and sixteen female patients, mean age 46+/-2 years, body weight less than 110% of I.B.W.) the determinations were made on blood samples drawn every 3 hrs. All the diabetic patients were insulin treated and were under good or discrete metabolic control, and presented advanced retinopathy. Both in the normal subjects and in retinopathic diabetics, the mean HGH curve showed a characteristic elevation during the early nighttime hours (between 21(00) and 02(00). Despite higher values in plasma glucose and FFA, in diabetics the nocturnal elevation of HGH was only slightly lower than in the normals. The comparison between daytime and nighttime determinations, both in the normal subjects and in the diabetics, reveals statistically significant differences. These results suggest that in subjects with diabetic retinopathy, in the phase of good or discrete metabolic control, spontaneous HGH secretion is not increased, and that nocturnal elevation of HGH is not substantially influenced by higher plasma levels of glucose and FFA. Ten days of plurichronocorticoid treatment with a new drug which exhausts its activity before the evening, did not modify the circadian rhythm of HGH.