Although liver cirrhosis causes significant modifications of GHB disposition kinetics, the increase in t1/2 is not such as to cause drug accumulation on repetitive dosing. However, in consideration of the higher mean plasma levels observed in cirrhotic patients, it appears wise to keep the initial GHB daily dose at the lower end of the therapeutic range and to carefully monitor the patients if upward dose adjustments are required.
In the present research, levels of gentamicin (GM) in serum and carrageenan pleural exudate from the rat have been compared, using three evaluation methods: microbiological assay (MA), enzyme-immunoassay (EMIT) and fluorescence-immunoassay (TDX). In a first study, the evaluations carried out by MA and EMIT have furnished comparable data in serum, while statistically significant differences were verified at all times in pleural exudate. On the contrary, in a second study, while the evaluations carried out by MA and EMIT, at all times and in both biological fluids, have produced similar data, the evaluation carried out by TDX consistently supplied higher results, with statistically significant differences at some times (5 min and 60 min for serum, 30 min and 60 min for exudate). Some possible interpretations of these results are discussed.
Italy has two different public healthcare services taking in care patients with dual diagnosis: (1) the mental health services (Centri di Salute Mentale - CSM) and (2) and the drug abuse services (Servizi per le Dipendenze - Ser.D.). We collected and analyzed data regarding the frequency of the co-morbidities in Veneto Region during 2019. Our study shows that only the 1% of the patients in treatment in the mental health services and the 8.7% of those in drug abuse services are recognized as dual diagnosed subjects. In drug abuse services the most frequent substance use disorders (SUD) correlated with a psychiatric disease were the alcohol and opioids use disorders, while the most prevalent psychiatric disorders associated with a SUD were the personality disorders and the schizophrenia, schizotypal and delusional disorders. Our data indicate that the diagnosis of co-morbidity should be improved in both services and that integrated programs between the above services should be developed to improve the best practices.
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