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1.
Recenti Prog Med ; 103(2): 79-84, 2012 Feb.
Article in Italian | MEDLINE | ID: mdl-22430754

ABSTRACT

Drug-induced liver injury represents the principal cause of acute liver failure and orthotopic liver transplantation in western country. A very large number of different drugs and medicinal herbs has been associated with liver injury but just for few of them we know the process that causes liver disease. All the people which ingest a large number of drugs present a risk of developing liver injury. Diagnosis is very difficult because a specific biomarker of damage is absent and the clinical picture is common to other liver diseases. A therapeutic approach is efficacy only in few cases. When a drug-induced liver injury is suspected, cessation of the drug is the first step in their management.


Subject(s)
Acetaminophen/adverse effects , Chemical and Drug Induced Liver Injury , Liver Failure, Acute/chemically induced , Algorithms , Amoxicillin/adverse effects , Analgesics, Non-Narcotic/adverse effects , Anesthetics, Inhalation/adverse effects , Anti-Bacterial Agents/adverse effects , Anti-Inflammatory Agents, Non-Steroidal/adverse effects , Antitubercular Agents/adverse effects , Chemical and Drug Induced Liver Injury/diagnosis , Halothane/adverse effects , Humans , Hypnotics and Sedatives/adverse effects , Isoniazid/adverse effects , Kava/adverse effects , Liver Failure, Acute/diagnosis , Risk Factors , Severity of Illness Index , Sulfonamides/adverse effects
2.
J Neurol Sci ; 288(1-2): 112-6, 2010 Jan 15.
Article in English | MEDLINE | ID: mdl-19836029

ABSTRACT

BACKGROUND: Type-2 Diabetes Mellitus (DM-2) is an important risk factor for Alzheimer disease (AD) and vascular dementia (VD). The role of insulinic therapy on cognitive decline is controversial. OBJECTIVE: To evaluate cognitive impairment in patients with AD and DM-2 treated with either oral antidiabetic drugs or combination of insulin with other diabetes medications. METHODS: 104 patients with mild-to-moderate AD and DM-2 were divided into two groups, according to antidiabetic pharmacotherapy: group A, patients treated with oral antidiabetic drugs and group B, patients treated with insulin combined with other oral antidiabetic medications. Cognitive functions were assessed by the Mini Mental State Examination (MMSE) and the Clinician's Global Impression (CGI), with a follow-up of 12 months. RESULTS: At the end of the study, the MMSE scores showed a significant worsening in 56.5% patients of group A and in 23.2% patients of group B, compared to baseline MMSE scores (P=.001). Also CGI-C scores showed a significant worsening for all domains after 12 months in group A vs group B (P=.001). The two groups were matched for body mass index, serum lipids, triglycerides, Apo epsilon4 allele and smoke habit. Conversely, ischemic heart disease and hypertension were significantly higher in group B (P=.002). After adjustment for this risk variables, our results remained significant (P=.001). CONCLUSIONS: Our study suggests that insulinic therapy could be effective in slowing cognitive decline in patients with AD.


Subject(s)
Alzheimer Disease/complications , Alzheimer Disease/drug therapy , Cognition Disorders/drug therapy , Cognition Disorders/etiology , Diabetes Complications/drug therapy , Diabetes Complications/psychology , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/psychology , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Aged , Alzheimer Disease/psychology , Apolipoproteins E/genetics , Blood Glucose/metabolism , Cognition Disorders/psychology , Data Interpretation, Statistical , Diabetes Mellitus, Type 2/complications , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Neuropsychological Tests , Tomography, X-Ray Computed
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