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.

Autologous conditioned serum for the treatment of osteoarthritis and other possible applications in musculoskeletal disorders

Abstract: Introduction: The therapeutic use of interleukin 1 (IL-1) cytokine receptor antagonists (IL-1RA) has promoted the development of new biological therapies for osteoarthritis (OA). Autologous conditioned serum (ACS) is an alternative, safe and well-tolerated treatment in OA. Sources of data: We performed a comprehensive search of PubMed, Medline, Cochrane, CINAHL, Embase, SportDiscus, Pedro and Google scholar databases using keywords such as ‘interleukin 1’, ‘osteoarthritis’ and ‘autologous conditioned serum’. Areas of agreement: ACS, containing endogenous anti-inflammatory cytokines including IL-1RA and several growth factors, could reduce pain and increase function and mobility in mild to moderate knee OA. Area of controversy: Given the limited data available on the composition of ACS, the mechanisms through which ACS produces clinical improvement, the duration of its effect and the changes in cytokine levels after repeated injections are still unknown. Growing points: Although previous clinical data are encouraging and confirm the safety of this modality, given the limitations of current studies, there should be additional, controlled trials to further confirm efficacy for the use of ACS in OA treatment.

Effects of sports activity in athletes with bicuspid aortic valve and mild aortic regurgitation

Abstract: Objective In this study, the impact of regular training on left ventricle morphology in a group of athletes with bicuspid aortic valve (BAV) was evaluated. Design Longitudinal cohort study. A group of competitive athletes with BAV was followed up with a yearly standard echocardiographic examination for 5 years. Setting Sport Medicine Centre, University of Florence, Pre-Participation Protocol Study Participants A group of 88 consecutive athletes diagnosed with BAV was identified in the period January to December 1999, and 30 of these completed a 5-year follow-up. They were compared with a group of 56 athletes with a normal tricuspid valve (TAV). Results BAV athletes showed significant progressive increase in left ventricular dimensions and aortic diameters at four levels. The values were within the range of the general and non-athletic BAV populations. In TAV athletes, the aortic and left ventricle dimensions did not increase significantly and remained within physiological range. Conclusions Left ventricular dimensions in competitive BAV athletes remain within the normal range. There is, however, a significant progressive increase in the BAV group compared with the TAV group. These results are in agreement with data obtained in previous studies on the non-athletic BAV population. Sports activity does not have an additional effect on cardiac morphology in athletes with asymptomatic BAV associated with mild regurgitation, for at least 5 years.

Glove perforation in elective orthopedic surgery

Abstract: A survey of glove perforation in 16 orthopedic surgeons during a 6-month period was carried out. During this time, the surgeons performed 304 elective operations. In 1,398 pairs of gloves tested, evidence of perforation was found in 26 percent.

Paediatric sports injuries in Hong Kong: a seven year survey.

Abstract: OBJECTIVE: To ascertain the epidemiological characteristics of sports injuries in children in Hong Kong. METHODS: Retrospective review of all cases seen in the Sports Injury Clinic of the Prince of Wales Hospital, Shatin, Hong Kong, in the period May 1984 to December 1990. The variables studied were age at presentation, gender, side of the body injured, anatomical location of the injury, type and severity of injury, sport played, level (school, recreational, amateur and professional) and frequency of sports participation, length in years of sports practice, and initial management of the injury. RESULTS: Of the 2293 patients seen, 238 were youngsters (54% boys) 16 years old or younger. Ball games accounted for the greatest number of injuries, with 37 children taking part in basketball, 28 in soccer, 12 in volleyball, and 31 children taking part in a variety of other ball games. Of the remaining children, the single largest group was practising track and field, with sprinting and middle distance running accounting for 42 injuries, and 28 children were injured while cycling. Most of the injuries (85%) were classified as non-serious, but 15% of children presented with a total of 21 fractures, two joint dislocations, five concussions, and seven torn knee ligaments. CONCLUSIONS: Children sports participation in Hong Kong, although not at high level and not as widespread as in the West, accounts for significant morbidity. These injuries should be carefully monitored to ascertain whether they result in any detrimental long term effects.

Eccentric training programmes in the management of lateral elbow tendinopathy

Abstract: Background. Eccentric training has shown promising results in the management of Achilles and patellar tendinopathy. Recently, studies have investigated eccentric training in the treatment of lateral elbow tendinopathy.Purpose. The purpose of this review was to describe eccentric training programs used to treat LET in order to inform clinicians and identify areas requiring further study.Method. An electronic search of publications indexed in the MEDLINE database was performed in May 2007. Studies comparing eccentric training with at least one other intervention were included.Results. Four studies investigating a total of 248 participants were identified. Three of the four studies reported superior results for eccentric training compared with other interventions, although this included one pilot study and another study that did not include an extended follow-up. There were several differences between the studies, including whether eccentric training was painful or pain-free, the duration of eccentric traini...

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