Publications by authors named "Kirill Micallef Stafrace"

Article Synopsis
  • Keloids and hypertrophic scars are raised skin lesions resulting from abnormal wound healing, traditionally treated with methods like dressings, steroids, and surgery.
  • Extracorporeal shock wave therapy (ESWT) is a non-invasive treatment that promotes tissue regeneration and has been assessed for its effectiveness against these types of scars.
  • Research indicates that ESWT may provide results similar to traditional steroid treatments, and when used in combination with them, it may enhance outcomes for keloids and hypertrophic scars, highlighting the need for further studies on its application in scar management.
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Non-communicable diseases (NCDs), including coronary heart disease, stroke, hypertension, type 2 diabetes, dementia, depression and cancers, are on the rise worldwide and are often associated with a lack of physical activity (PA). Globally, the levels of PA among individuals are below WHO recommendations. A lack of PA can increase morbidity and mortality, worsen the quality of life and increase the economic burden on individuals and society.

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Background: Managing and rehabilitating Achilles tendinopathy can be difficult, and the results are often unsatisfactory. Currently, clinicians use ultrasonography to diagnose the condition and predict symptom development. However, relying on subjective qualitative findings using ultrasound images alone, which are heavily influenced by the operator, may make it difficult to identify changes within the tendon.

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Supersonic shear wave (SW) elastography has emerged as a useful imaging modality offering researchers and clinicians a fast, non-invasive, quantitative assessment of tendon biomechanics. However, the exact relationship between SW speed and in vivo tendon stiffness is not intuitively obvious and needs to be verified. This study aimed to explore the validity of supersonic SW elastography against a gold standard method to measure the Achilles tendon's in vivo tensile stiffness by combining conventional ultrasound imaging with dynamometry.

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Shoulder dystocia, or shoulder entrapment at birth, is an obstetrician's nightmare, which not infrequently leads to court litigation with complaints of serious foetal and/or maternal damage. Increasingly, retrospective management scrutiny is extending well beyond second stage birth mechanics and involving all case file entries, history taking, ultrasound scan measurements and haematology profile results, etc. The article highlights some medico-legal issues including the influence of the ruling on patient disclosure and subsequent management.

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The European Medicines Agency's Pharmacovigilance Risk Assessment Committee has issued statements regarding limiting the use of high-dose oestradiol creams by women experiencing the genitourinary syndrome of menopause, and such statements carry much medicolegal weight. Although a low dose is most often used, some clinicians opt to use higher dose creams with close monitoring of the patient. The committee should publish the evidence behind these statements or amend its official position.

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No amount of symposia and clinical meetings and formal management will make a clinical difference unless obstetric units regularly and ruthlessly self-assess to curb medical negligence. Court case, which represent a small portion of substandard outcomes, not infrequently reveal a serious lack of obstetric judgment as well as paucity of knowledge which are compatible with unsupervised responsibility of labour ward duties. One UK court case presents a factual picture of obstetric practice which is difficult to reconcile with modern UK practice.

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Background: Athletes present a different category of the population. Trivial complaints may mask more serious illness, especially when the athlete is undergoing intensive training, and the function of his immune system may be sub-optimal.

Case Presentation: A triathlete presented a few days after completing an Ironman race, complaining of lethargy, pleuritic chest pain and loss of appetite.

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