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Purpose: Exercise exerts various effects on the immune system, and evidence is emerging on its anti-inflammatory effects; the mechanisms on the basis of these modifications are poorly understood. Mitochondrial DNA (mtDNA) released from damaged cells acts as a molecule containing the so-called damage-associated molecular patterns and can trigger sterile inflammation. Indeed, high plasma levels of mtDNA are associated to several inflammatory conditions and physiological aging and longevity. The authors evaluated plasma mtDNA in professional male volleyball players during seasonal training and the possible correlation between mtDNA levels and clinical parameters, body composition, and physical performance. Methods: Plasma mtDNA was quantified by real-time PCR every 2 mo in 12 professional volleyball players (PVPs) during 2 consecutive seasons. As comparison, 20 healthy nonathlete male volunteers (NAs) were analyzed. Results: The authors found lower levels of mtDNA in plasma of PVPs than in NAs. However, PVPs showed a decrease of circulating mtDNA only in the first season, while no appreciable variations were observed during the second season. No correlation was observed among mtDNA, hematochemical, and anthropometric parameters. Conclusions: Regular physical activity appeared associated with lower levels of circulating mtDNA, further confirming the protective, anti-inflammatory effect of exercise. [ABSTRACT FROM AUTHOR]

Medicalization (abuse of sport drinks, supplements and drugs) involves more and more of the sport world, casting doubt on the credibility of results. causes and responsibilities are individuated. Characteristics of two commonly used supplements (creatine, branched-chain amino acids) are analyzed in order to show risks and ambiguities for athletes and the way to come out of it.

The negative relationship between performance and iron deficiency anemia is well known. There is still debate in the literature on the exercise-induced iron loss and if low iron store, even in the absence of frank anemia, can adversely affected performance of elite athletes. We analyse the physiologic changes induced by strong exercise, the diagnostic problems and therapeutic supplementation.

From "Lou" Gehirg to Gianluca Signorini: the history of almost 70 years of link between amyotrophic lateral sclerosis and sport. From first intuitions and assumptions to late epidemiological evidences supporting the possible relation between Italian soccer and amyotrophic lateral sclerosis; comparison among old and new aetiopathogenetic hypothesis.

A laparoscopic cholecystectomy in cirrhosis was complicated by bile ascites and evolved in bile peritonitis. Starting from the differential diagnosis problem between ascitic decompensation and bile-peritonitis caused by a biliary tree damage, we reviewed the literature about post-cholecystectomy damages suggesting a flow chart about this topic.

Blood Doping has recently obtained a large diffusion between professional and nonprofessional athletes, in particular for endurance sports it has almost become a necessary way to warrant best performance. Seven years after the publication of our article "Blood Doping", this second installment was born to emphasize the way the biomedical research supplies (often unintentionally) new drugs and new technology to improve athletic performance and, on the other hand, to underline the antidoping strategies.

For best management of the diabetic patient and the cost-benefit relationship of bedside blood glucose monitoring use in hospital, we suggest an acting algorithm based on literature directions and on the clinical experience of an Internal Medicine Department.

The continued controversy regarding doping in Italian soccer turns the discussion to the use of food integration in sports. In Italy, there is only the word "integrator" to name many products so different regarding biological features and indication usage. We think it is useful, first of all, to talk about the meaning of integration, and then to introduce the differences between nutritional ergogenic aids and supplements and, finally, to think through relationship between nutrition and athletic performance. On the basis of recent literature, there is no evidence of any real benefit for athletes in taking nutritional ergogenic aids or supplements.

The latest AIDS' congress (Barcelona) reminded the world this dramatic situation. The shown data are remarkable: 5 million people of new infected in 2001, 68 million people could die in the next 20 years because of AIDS and the biggest part of them is living in the South of the world. There are two different kind of AIDS: the AIDS of rich people (2% of infected ones), who can reach the modern therapies that changed the course of the disease now curable out of hospital, and the AIDS of poor ones, without therapies and future. The political-economic effort of Western governments, of global fund anti-AIDS and of non governmental organizations now is not able to answer to this emergency in the right way. The lacking sensibility of Western doctors and the inflexible position of Catholic Church about contraception make the situation more complicated. It's hopeful the overcoming of this position using a Catholic Church's precious concept: the distinction between "simpliciter" and "secundum quid" to agree the use of condoms in case of absolute need.

Between 1991 and 1998, 45 cirrhotic patients with hepatocellular carcinoma (1 or 2 lesions smaller than 5 cm) were treated either with percutaneous ethanol injection (26 patients) or with trans arterial chemoembolization (19 patients) in our Department. Percutaneous ethanol injection was performed on 37 nodules: mean diameter of 3.1 +/- 0.8 cm. Transarterial chemoembolization was performed on 27 nodules: mean diameter of 2.8 +/- 0.7 cm. Therapeutic success at first treatment was obtained in 81.5% of percutaneous ethanol injection treated lesions and in 60.0% of trans arterial chemoembolization treated lesions. Local recurrence after first treatment occurred in 7 of 22 percutaneous ethanol injection patients (31.8%) and 8 of 15 transarterial chemoembolization patients (53.3%). Distant hepatic recurrence after first treatment occurred in 16 of 26 (61.5%) alcolization treated patients and in 14 of 25 (56.0%) chemoembolization treated. Multivariate analysis selected therapeutic success and modality of treatment as the best predictor of better survival probability in all treated patients. Survival probability at 12/24/36/48 months was 96.1/80.8/61.6/42.3% in percutaneous ethanol injection group and 89.5/68.4/36.8/15.8% in transarterial chemoembolization group (p < 0.05 Log rank). Few data are available comparing the efficacy of percutaneous ethanol injection and transarterial chemoembolization in patients with hepatocellular carcinoma. Our data confirm that percutaneous ethanol injection is better than trans arterial chemoembolization in the treatment of patients with one or two lesions of hepatocellular carcinoma.