The Acromegaly Syndrome: RELATION BETWEEN CLINICAL FEATURES, GROWTH HORMONE VALUES AND RADIOLOGICAL CHARACTERISTICS OF THE PITUITARY TUMOURS

One hundred and fifty-five acromegalics, 76 males (mean age44 ± 1.3 years) and 79 females (45 ± 1.4 years)were studied. The frequency of clinical features were: acralenlargement 100 per cent, hyperhidrosis 65 per cent, headache55 per cent, paraesthesiae 49 per cent, cardiac problems 34per cent, hypertension 32 per cent, diabetes mellitus (clinicaland chemical) 27 per cent, and visual field defects 6 per centSigns and symptoms, and particularly headache, did not showany relation with the size or shape of pituitary tumours, norwith growth hormone (GH) values, age, sex or weight Mean ofGH values at 60, 90 and 120 minutes during a GTT averaged 135mIU/I, range 8–1833. Diabetes mellitus was more frequentand severe in patients with higher GH values, occurring in 32per cent of patients with mean GH values 50 mIU/1 and only in16 per cent of the rest (p < 0.05). GH values correlated positively with size of tumours. Forty-nineper cent of patients presented with entirely intrasellar tumours,27 per cent with suprasellar extensions and 23 per cent withpartially empty sellae. The mean GH (238 mIU/I) of patientswith suprasellar extensions was significantly higher (p <0.004) than those of the others. Younger acromegalics showeda tendency to larger tumours. Early treatment of acromegaly, particularly in young patientsand those presenting with high GH values, is recommended.     

Medical students'' attitudes to psychiatry in Chile

There is controversy about the influence of psychiatric clerkships on medical students' attitudes to psychiatry. In general, studies in developed countries have found a short-lasting improvement in attitudes to psychiatry after a psychiatric clerkship. The present study was designed to measure changes in medical students' attitudes following a psychiatric clerkship in a developing country. Medical students from the Faculty of Medicine, University of Chile were interviewed before and after a psychiatric clerkship using a translation into Spanish of an attitude-to-psychiatry questionnaire used previously in the UK. The results were similar to those reported from developed countries. There was a marked early improvement in students' attitudes following their psychiatric clerkship which gradually faded over 3 years. There is scope for improvement in psychiatric undergraduate medical teaching in Chile and this might help to make more lasting improvements in attitudes to psychiatry among medical students.