Subacute cognitive disorders as initial presentation of intravascular lymphoma: a case report and review of literature.

Intravascular lymphoma is a rare subtype of diffuse large B cell lymphoma, characterized by proliferation of mature B cells within the lumina of small and medium vessels of many organs, without parenchymal involvement. The clinical phenotype is extremely variegated; moreover, neurological symptoms such as encephalopathy and focal neurological deficits occur and often coincide with disease's debut. We described the clinical course of a patient with intravascular diffuse large B cell lymphoma presented with subacute cognitive decline without focal signs, later associated to aspecific general symptoms that rapidly evolved to a severe inexplicable encephalopathy accompanied to systemic failure.

Suicidal behaviour in nursing homes: a survey in a region of north-east Italy.

OBJECTIVE: To assess suicide and attempted suicide (AS) rates and their characteristics among older residents in Nursing Homes (NHs) of the Veneto region, in the North-East of Italy. METHOD: The complete list of NHs was provided by the Regional Department of Health. Structured interviews were completed with NH managers, inquiring about NH, staff and management characteristics, mental health care available and the number of completed and attempted suicides (AS) in 2001 made by residents older than 65 years, occurring either inside or outside NHs. All facilities which reported suicidal events were asked additional information. RESULTS: In the study period, five completed suicides and eight AS were reported, i.e. a rate of 18.6/100,000 and of 29.7/100,000 respectively. All but one suicides and one AS had a history of mental disorders. Seven subjects had been living in a NH for less than one year. There were no significant differences in the frequency of suicidal events between the facilities which employed or did not employ mental health workers. CONCLUSION: The suicide rate found in this facility sample is much higher than the rate reported by the Italian National Statistic Institute for the over-65-year-old population of the Veneto Region in 2001, and is similar to the rate reported in a previous study conducted in another country. In Veneto NHs behavioural control of residents, lack of access to a variety of means used for suicidal purposes and medical supervision does not seem to have protected the NH population from suicidal risks.