[Use of naltrexone in the treatment of opiate addicts. Efficacy and indications for type categories]. / L'utilizzo del naltrexone nella terapia delle tossicodipendenze da oppiacei. Efficacia ed indicazioni per categorie tipologiche.

Naltrexone is a pure narcotic antagonist with optimum pharmacologic properties for the long-term management of opiate addiction. The above study confirms the usefulness of naltrexone for the prevention of relapse in subjects who have been weaned from narcotics. However, the short follow up does not yet permit evaluation of its medium and long-term efficacy. The better course and outcome of treatment are significantly related to certain characteristics and types of addicts. It may be said that by assuring complete, albeit time-limited, remission the antagonist allows the addict to open a window through which to face the world, and offers the therapist the possibility to apply all the instruments at his disposal in an effective manner.

The treatment of unstable type I diabetes: conventional versus portable pump insulin administration.

The treatment of unstable insulin-dependent diabetics (UIDD) is still an unsolved problem. A comparison was made between optimized conventional treatment (OCT) (Ultralente + Actrapid at breakfast, Actrapid at lunch and Actrapid at dinner) and continuous s.c. insulin infusion (CSII) for 30 days in 10 UIDD outpatients. Continuous 24-h blood glucose monitoring with an artificial pancreas, fasting values of HbA1, plasma lipids, growth hormone, glucagon, daily urinary glucose and protein excretion were recorded after each treatment; a daily blood glucose profile was determined every week. Daily mean blood glucose values dropped significantly (p less than 0.01): from 187.2 +/- 66.6 (OCT) to 111.6 +/- 27.0 mg/dl (CSII), and hypoglycemic and ketotic events disappeared during CSII. A significant improvement (p less than 0.01 - p less than 0.001) in all other parameters was also observed. It is suggested that CSII may help to improve metabolic control and the quality of life in UIDD.