Nicola Maffulli

Bio: Nicola Maffulli is an academic researcher from University of Salerno. The author has contributed to research in topics: Achilles tendon & Tendinopathy. The author has an hindex of 115, co-authored 1570 publications receiving 59548 citations. Previous affiliations of Nicola Maffulli include University of Aberdeen & University of Sydney.

Epidemiology and genetic theories in the etiology of congenital talipes equinovarus.

Abstract: The exact genetic mechanism of inheritance of congenital talipes equinovarus (CTEV) has been extensively investigated using family studies and other epidemiological methods, but to date no conclusive result has been reached. This may be due to the presence of a number of inheritance patterns, a number of different etiologies presenting as the same morphological condition, or complex gene-environment interactions. Indeed, a number of epidemiological factors have also been implicated in the etiology. While epidemiological studies can suggest inheritance patterns, only by identification of specific genes, can inheritance patterns be proven. This article reviews the epidemiological work on the etiology of CTEV and discusses some of the epidemiological principles involved.

Avulsion of the tibial tuberosity: muscles too strong for a growth plate.

Abstract: PURPOSE To ascertain whether there were significant knee extension strength differences between two adolescent male gymnasts (patient 1: age, 14.5 years; height, 159.3 cm; weight, 52.2 kg; patient 2: age, 15 years; height, 160.6 cm; weight, 54.8 kg) with avulsion of the tibial tuberosity associated with avulsion of the patellar tendon. CASE SUMMARY Two adolescent male gymnasts underwent open reduction and internal fixation for avulsion of the tibial tuberosity associated with avulsion of the patellar tendon. Isometric extension strength of the contralateral uninjured knee and of the operated knee was significantly greater than for nonathletic adolescents of the same age (one-way analysis of variance [ANOVA], p = 0.001), and was at a higher part of normal strength than their gymnastic peers. DISCUSSION A maximal contraction of the quadriceps is able to overcome the strength of the upper tibial epiphysis disrupting the extensor mechanism of the knee. RELEVANCE Greater-than-usual strength, although normally of no undesired consequence, may play a role in avulsion injuries of major muscles.

Hip scores: A current concept review.

Abstract: Introduction During the past decades, several rating scales have been developed to assess the functional status of patients with hip pain. Source of data A search in Medline, PubMed, Cochrane and CINAHL was performedusing combinations of the following'hip', 'scoring system', 'scale', 'scores', 'outcome assessment', 'arthroplasty', 'arthroscopy' and 'clinical evaluation'. Areas of agreement A total 16 scoring systems are currently available for the evaluation of the hip. Areas of controversy Two types of questionnaires are available: physician-rated and patient-rated questionnaires. Growing points Each hip score consists of different domains. Interpreting these domains becomes sometimes difficult, because, even though they can be common to more than one scoring system, each stresses them in a different way. Areas timely for developing research Although many scoring systems have been used to evaluate hip function, we are still far from a single outcome evaluation system which is reliable, valid and sensitive.

Effects of a home-based exercise rehabilitation program for cancer survivors.

Abstract: BACKGROUND Aerobic and resistance exercises have been promoted recently to improve quality of life in cancer patients. Most cancer survivorship rehabilitation programs consist of supervised exercise programs; however, less data is available on the effects of unsupervised or home-based exercise interventions. The study aimed to compare the physical and physiologic changes in a group of cancer survivors (CS) and a control group of non-cancer, health controls (HC) who participated in individualized home-based aerobic and resistance exercises for 12 months. METHODS Thirty-three surviving cancer survivors (CS) aged 55.6±3 years were enrolled for 1 year of unsupervised exercise prescription programs. Anthropometric parameters hydration status, fitness, and echocardiographic examination were measured every six month and compared to10 HC (aged 52.6±7.7 years) individuals prior to starting the program (t0) and at 6 (t6) and 12 (t12) months. RESULTS Among the CS subjects, a significant reductions in waist circumference (t0: 97.5±15.2 cm, t6: 86.6±13.5 cm, t12: 85.8±13.9 cm; P<0.05), body cell mass (t0: 50.9±4.7%, t6: 52.3±4.4%, t12: 53.7±3.7%; P<0.05), and extracellular mass (t0: 49.1±4.7%, t6: 47.6±4.4%, t12: 46.2±3.7%; P<0.05) were observed, as well significant improvements in lower body muscle strength (chair test t0: 13.3±4.1, t6: 14.2±3.5, t12: 15.1±3.2; P<0.05). Changes in functionality and heart function were similar between CS and HC. CONCLUSIONS Individually-prescribed home-based exercise programs were cost effective, safe and resulted in modest improvements in body composition, strength, and total body water distribution with little to no adverse effect on cardiac function.

I and i

Abstract: There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality. Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

Standards of Medical Care in Diabetes

Abstract: XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012)

Abstract: ABI : ankle–brachial index ACCORD : Action to Control Cardiovascular Risk in Diabetes ADVANCE : Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation AGREE : Appraisal of Guidelines Research and Evaluation AHA : American Heart Association apoA1 : apolipoprotein A1 apoB : apolipoprotein B CABG : coronary artery bypass graft surgery CARDS : Collaborative AtoRvastatin Diabetes Study CCNAP : Council on Cardiovascular Nursing and Allied Professions CHARISMA : Clopidogrel for High Athero-thrombotic Risk and Ischemic Stabilisation, Management, and Avoidance CHD : coronary heart disease CKD : chronic kidney disease COMMIT : Clopidogrel and Metoprolol in Myocardial Infarction Trial CRP : C-reactive protein CURE : Clopidogrel in Unstable Angina to Prevent Recurrent Events CVD : cardiovascular disease DALYs : disability-adjusted life years DBP : diastolic blood pressure DCCT : Diabetes Control and Complications Trial ED : erectile dysfunction eGFR : estimated glomerular filtration rate EHN : European Heart Network EPIC : European Prospective Investigation into Cancer and Nutrition EUROASPIRE : European Action on Secondary and Primary Prevention through Intervention to Reduce Events GFR : glomerular filtration rate GOSPEL : Global Secondary Prevention Strategies to Limit Event Recurrence After MI GRADE : Grading of Recommendations Assessment, Development and Evaluation HbA1c : glycated haemoglobin HDL : high-density lipoprotein HF-ACTION : Heart Failure and A Controlled Trial Investigating Outcomes of Exercise TraiNing HOT : Hypertension Optimal Treatment Study HPS : Heart Protection Study HR : hazard ratio hsCRP : high-sensitivity C-reactive protein HYVET : Hypertension in the Very Elderly Trial ICD : International Classification of Diseases IMT : intima-media thickness INVEST : International Verapamil SR/Trandolapril JTF : Joint Task Force LDL : low-density lipoprotein Lp(a) : lipoprotein(a) LpPLA2 : lipoprotein-associated phospholipase 2 LVH : left ventricular hypertrophy MATCH : Management of Atherothrombosis with Clopidogrel in High-risk Patients with Recent Transient Ischaemic Attack or Ischaemic Stroke MDRD : Modification of Diet in Renal Disease MET : metabolic equivalent MONICA : Multinational MONItoring of trends and determinants in CArdiovascular disease NICE : National Institute of Health and Clinical Excellence NRT : nicotine replacement therapy NSTEMI : non-ST elevation myocardial infarction ONTARGET : Ongoing Telmisartan Alone and in combination with Ramipril Global Endpoint Trial OSA : obstructive sleep apnoea PAD : peripheral artery disease PCI : percutaneous coronary intervention PROactive : Prospective Pioglitazone Clinical Trial in Macrovascular Events PWV : pulse wave velocity QOF : Quality and Outcomes Framework RCT : randomized clinical trial RR : relative risk SBP : systolic blood pressure SCORE : Systematic Coronary Risk Evaluation Project SEARCH : Study of the Effectiveness of Additional Reductions in Cholesterol and SHEP : Systolic Hypertension in the Elderly Program STEMI : ST-elevation myocardial infarction SU.FOL.OM3 : SUpplementation with FOlate, vitamin B6 and B12 and/or OMega-3 fatty acids Syst-Eur : Systolic Hypertension in Europe TNT : Treating to New Targets UKPDS : United Kingdom Prospective Diabetes Study VADT : Veterans Affairs Diabetes Trial VALUE : Valsartan Antihypertensive Long-term Use VITATOPS : VITAmins TO Prevent Stroke VLDL : very low-density lipoprotein WHO : World Health Organization ### 1.1 Introduction Atherosclerotic cardiovascular disease (CVD) is a chronic disorder developing insidiously throughout life and usually progressing to an advanced stage by the time symptoms occur. It remains the major cause of premature death in Europe, even though CVD mortality has …

Harrison's Principles of Internal Medicine

Abstract: The 11th edition of Harrison's Principles of Internal Medicine welcomes Anthony Fauci to its editorial staff, in addition to more than 85 new contributors. While the organization of the book is similar to previous editions, major emphasis has been placed on disorders that affect multiple organ systems. Important advances in genetics, immunology, and oncology are emphasized. Many chapters of the book have been rewritten and describe major advances in internal medicine. Subjects that received only a paragraph or two of attention in previous editions are now covered in entire chapters. Among the chapters that have been extensively revised are the chapters on infections in the compromised host, on skin rashes in infections, on many of the viral infections, including cytomegalovirus and Epstein-Barr virus, on sexually transmitted diseases, on diabetes mellitus, on disorders of bone and mineral metabolism, and on lymphadenopathy and splenomegaly. The major revisions in these chapters and many