Non-alcoholic fatty liver disease has become the leading chronic liver disease in the developed world, with a prevalence of 6%-35%. Its pathological spectrum ranges from simple steatosis (non-alcoholic fatty liver) to different degrees of inflammation and liver cell damage [non-alcoholic steatohepatitis (NASH)]. NASH has gained attention in recent years because of its association with hepatocellular carcinoma (HCC). Although the occurrence of HCC is more frequent in the presence of cirrhosis, studies have shown that hepatic carcinogenesis may also develop in the context of NASH without association with advanced fibrosis, as well as from simple steatosis. Evidence of the onset of HCC in the absence of cirrhosis is of concern, since recent surveillance and screening guidelines for liver cancer do not include this population subgroup. Therefore, it is imperative that new effective screening and monitoring measures for HCC, or even the reformulation of these recommendations, be taken to handle these patients considered to be at high risk. The present paper aims to review the literature on the occurrence of HCC in patients with NASH with or without cirrhosis. In addition, we report a case showing the development of HCC in a patients with NASH without cirrhosis.

Objectives: Cozart-test is a non-invasive instrument detecting recent use/abuse of drugs in oral fluid, largely employed in many environments including law enforcement. The present study aims to evaluate the prevalence of drug-use and its correlates in car-drivers in a wealthy area in Northern Italy. Methods: The study-population consists of 67 subjects recruited by policemen in Bologna and surroundings. An alcohol-test was administered to all the drivers. The Cozart-test was administered only to a persons with a positive result to the alcohol-test. A semi-structured interview was also administered together with a brief clinical assessment. Results: Drug-users were more frequently men (86,6%) of Italian origin (97%) and were often stopped nearby discos. A positive history of substance abuse was prevalent especially among subjects between 26 and 30 years of age (8,3%). Alcohol and Delta-tetrahydrocannabinol (THC) were the type of substances most commonly declared. Cozart-test resulted positive in one out of three participants. The Cozart-test largely confirmed the use of cocaine (17,6%) and two or more substance simultaneously (41,2%). Conclusions: According to the most recent literature, our findings suggest that cocaine and THC are the substances more frequently used within recreational setting, confirming the poor perception of risk by young people, looking mainly for the disinhibiting and entactogen effects of these psychoactive drugs.

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Objectives: To evaluate the features of Frequent-Attenders (FAs) admitted to an Acute Psychiatric Unit of a general hospital in Bologna, Northern Italy. Methods: Persons admitted between January 2008-June 2009 (N=110) were randomly selected thanks to the Hospital Information System. All participants' admissions in the indexed period were recorded, the case-history of the first admission was reviewed gathering socio-demographic and clinical information. The International Classification of Disease (ICD-10) was used for diagnosis. FAs were defined for 3 or more admissions within 18 months (Botha et al. 2009). Results: Almost one out of three patients was a FA (N=34; 30.9%). The mean number of admission for each subject being 5.6±3.4 for an average length of stay of 56.2±62.1 days. In comparison to single users, FAs were more frequently men (67.6% vs. 46.1%; p=0.029), unemployed (79.4% vs. 29.2%; p< 0.001) and living in social-health facilities (29.4% vs. 9.5%; p< 0.024). FAs and common users were not different concerning compulsory/voluntary admission. Schizophrenia and other Psychotic Disorders were predominant among FAs (44.1%), followed by Substance Use and Personality Disorders (14.7%), but no differences were detectable between cases and controls in terms of discharge diagnoses. Conversely, the prevalence of concomitant organic diseases was higher in FAs (50% vs. 27.6%; p=0.020).Finally, the results of the Logistic Regression Model estimating Odds Ratios and 95% Confidence Intervals suggested that FAs had a lower insight/compliance (2.15; 2.50-29.66; p=0.001). Conclusions: FAs have a higher mental-social disability. A targeted treatment might reduce the frequency of hospitalization.