Drug-induced lipid accumulation in the liver may induce two clinically relevant conditions, drug-induced steatosis (DIS) and drug-induced steatohepatitis (DISH). The list of drugs that may cause DIS or DISH is long and heterogeneous and includes therapeutically relevant molecules that cannot be easily replaced by less hepatotoxic medicines, therefore making specific strategies necessary for DIS/DISH prevention or treatment. For years, the only available tools to achieve these goals have been antioxidant drugs and free radical scavengers, which counteract drug-induced mitochondrial dysfunction but, unfortunately, have only limited efficacy. In the present review we illustrate how in vitro preclinical research unraveled new key players in the pathogenesis of specific forms of DISH, and how, in a few cases, proof of

Immune checkpoint inhibitors represent one of the most significant recent advances in clinical oncology, since they dramatically improved the prognosis of deadly cancers such as melanomas and lung cancer. Treatment with these drugs may be complicated by the occurrence of clinically-relevant adverse drug reactions, most of which are immune-mediated, such as pneumonitis, colitis, endocrinopathies, nephritis, Stevens Johnson syndrome and toxic epidermal necrolysis. Drug-induced steatosis and steatohepatitis are not included among the typical forms of cancer immunotherapy-induced liver toxicity, which, instead, usually occurs as a panlobular hepatitis with prominent lymphocytic infiltrates. Nonetheless, non-alcoholic fatty liver disease is a risk factor for immunotherapy-induced hepatitis, and steatosis and steatohepatitis are frequently observed in this condition. In the present review we discuss how these pathology findings could be explained in the context of current models suggesting immune-mediated pathogenesis for steatohepatitis. We also review evidence suggesting that in patients with hepatocellular carcinoma, the presence of steatosis or steatohepatitis could predict a poor therapeutic response to these agents. How these findings could fit with immune-mediated mechanisms of these liver diseases will also be discussed.

The home management of children with congenital heart disease (CHD) in the postsurgical phase represents one of the most complex phases for their parents. To date, the information available in the scientific landscape regarding the experiences and difficulties faced by the parents of children with CHD during this phase is still lacking. Accordingly, the study aims to synthesize the available qualitative evidence on parents’ experience during the home care management of children with CHD after cardiac surgery. Two databases were systematically searched to identify qualitative studies relating to parental experience about the home care management of children with CHD after cardiac surgery. Studies were carried out using Noblit and Hare's meta-ethnographic approach. The search yielded 183 results. After applying the inclusion criteria, nine articles were included in the meta-synthesis. The included articles were analyzed following the meta-ethnography approach. Five main themes were identified: (a) psychological and emotional impact and daily challenges; (b) continuity of care; (c) loneliness, isolation, and the need for knowledge; (d) new parental role; (e) assistance and support. The role of parents in the postsurgical phase of children with CHD is essential. However, numerous psychological nuances and emotional contradictions emerged from the experience of parents involved in this phase. Further studies are needed to identify parenting health and psychosocial support improvement strategies at home.