(Adnkronos) - In questo numero:
Alla base di una vita più o meno in salute: geni ereditati dai genitori, microbioma e “adattoma”
Bassi livelli di albumina nel sangue predicono rischio morte. Lo studio
Sinu, nutrizione di precisione può aiutare a prevenire e curare il diabete
A seguire lo Speciale Salus Tv dal titolo: Compie 30 anni il primo Servizio ambulatoriale ospedaliero di medicina estetica. Bartoletti della Sime: “una innovazione incredibile”
Alla base di una vita più o meno in salute: geni ereditati dai genitori, microbioma e “adattoma”
Bassi livelli di albumina nel sangue predicono rischio morte. Lo studio
Sinu, nutrizione di precisione può aiutare a prevenire e curare il diabete
A seguire lo Speciale Salus Tv dal titolo: Compie 30 anni il primo Servizio ambulatoriale ospedaliero di medicina estetica. Bartoletti della Sime: “una innovazione incredibile”
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NewsTranscript
00:00In this number, at the base of a life more or less healthy, genes inherited by parents microbiome and adatoma.
00:17Low levels of albumin in the blood predict the risk of death, the study.
00:21And again, SINU, precision nutrition, can help prevent and cure diabetes.
00:27To follow the special Salus TV.
00:29From the title, 30 years old, the first hospital ambulatory service of aesthetic medicine.
00:34Bartoletti della Sime, an incredible innovation.
00:43The intestinal microbiome, that universe of microorganisms, bacteria, viruses, protozoa and fungi,
00:48that live in our body, is closely related to the good functioning of our immune system
00:53and the ability it has to defend us even from the emergence of tumors.
00:56Today, then, in the fight against this type of pathologies, the immunotherapy is being affirmed more and more,
01:00to which about 30-40% of the patients fully respond.
01:04A situation that, as explained by Prof. Attilio Giacosa,
01:07already director of the complex structure of gastroenterology and clinical nutrition
01:10of the National Institute for Cancer Research in Genoa,
01:13and the gastroenterologist at the Italian Diagnostic Center in Milan,
01:16in the course of the online event of the table to the immune system
01:19the role of the intestinal microbiome, organized by Assosalute,
01:22seems to be improvable precisely with the modulation of the microbiota.
01:25Yes, the immunotherapy is becoming a chapter of enormous significance,
01:29especially in extremely serious pathologies, such as melanoma,
01:32rather than lung tumors,
01:35and represents an ability to expand survival
01:39in patients who were deemed terminal
01:42and who had no other possible treatment until recently.
01:45So it's a chapter of great, great fascination.
01:48But how does it happen? In every type of therapy there are responders and non-responders.
01:53And what has been seen is that,
01:56using in particular the muciniferous achermansia,
01:59well, the greater or lesser availability
02:02in the microbiota of a patient of this bacterium
02:05ensures that there is a greater or lesser response to the immunotherapy.
02:10So now we are studying the way to enrich in muciniferous achermansia
02:16the microbiota of subjects that go against this therapy,
02:20because the differences are extremely important
02:23and, I repeat, this constitutes a first step, a first example
02:28of how you can really get through the study, the analysis
02:34and possibly also the modulation of the microbiota
02:38to results that could have been absolutely unthinkable until recently.
02:43Not only that, this particular bacterium also performs other very important functions,
02:48starting with the anti-inflammatory one.
02:51The lack of achermansia increases the inflammatory state of our microbiota,
02:56participates in a lower integrity of the intestinal barrier,
03:01that is, negative also for this, the lack always,
03:04and reduces, modulates, modulates negatively the immune response.
03:18A joint research conducted at the University of Sapienza in Rome
03:21in collaboration with IRCS Neuromedica di Pozzigli,
03:23Mediterranea Cardiocentro di Napoli
03:25and Università Lume Giuseppe De Gennaro di Casa Massimo in the province of Bari
03:29highlighted a significant association between hypoalbuminemia,
03:32that is, low levels of albumin in the blood,
03:34and an increase in the risk of mortality for all causes,
03:37also for school diseases and cancer, in particular in the over 65s.
03:41The research, published in the scientific journal E-Clinical Medicine Lancet,
03:45has been conducted on the basis of data collected since March 2005
03:48on 25,000 residents in Molise,
03:50participating in the epidemiological study Molisani.
03:53The aim is to know the environmental and genetic factors
03:56at the basis of cardiovascular and tumoral diseases.
03:58But why albumin?
04:00We asked Augusto di Castelnuovo,
04:02from the Department of Epidemiology and Prevention of IRCS Neuromedica di Pozzigli,
04:05province of Sermia.
04:06Albumin is a circulating protein
04:09that plays an important role of regulation in various processes
04:14and, among other things, it also has antioxidant properties.
04:17Low levels of albumin are known to be related to a series of pathologies,
04:22but one of the characteristics of our study
04:25is to have checked all these conditions.
04:28In particular, subjects with a personal history of cardiovascular,
04:34tumoral or renal pathologies,
04:38or acute or acute inflammation
04:41on conditions that lead to low levels of albumin.
04:45The population analyzed consists of 18,000 individuals
04:49of the Molisani project,
04:52followed by a follow-up of 13 years,
04:55during which about 1,400 fatal events have been recorded.
05:00The population was divided on the basis of albumin levels
05:04and it was observed that those who had albumin levels below a standard
05:09identified in 35 grams per liter
05:12went against a mortality rate higher than about 60%.
05:19The association is particularly evident in elderly subjects,
05:23where the death rate increases by 80%.
05:27The study therefore provides a reference value
05:29that can better guide the doctor in the interpretation of albumin measurement.
05:33The threshold of 35 grams per liter
05:36could be easily used to identify subjects at risk
05:42as a result of low levels of albumin and the absence of pathologies that determine it.
05:55In recent years, precision nutrition
05:58under the spotlight of the medical-scientific community
06:01has deserved a session dedicated to the 44th National Congress of the SINU,
06:06the Italian Society of Human Nutrition, held in Piacenza.
06:10It is a science that aims at a personalization approach
06:13of nutritional interventions
06:15on the basis of the characteristics of the individual
06:18for the prevention and treatment of some of the main chronic pathologies,
06:22including diabetes,
06:23whose prevalence is estimated to increase by 60% in the next decades,
06:28hitting 1.3 billion people in 2050.
06:32For precision nutrition,
06:34the mechanisms at the base of the effects of food and nutrients on health
06:39vary from individual to individual
06:41and the relationship between diabetes and nutrition is as narrow and dangerous as possible.
06:45The quality and quantity of the food we consume
06:48strongly influences the risk of developing the pathology of sweet blood
06:53and the way in which we can keep it under control
06:56or even make it regress.
06:58Current knowledge increasingly highlights
07:01how diabetes is a disease with very heterogeneous causes
07:05and the factors that contribute to its appearance and its severity
07:09are different from person to person.
07:11It is therefore likely that different foods play a specific role
07:15in different individuals in the various phases of the disease,
07:18interacting with genetics and other individual characteristics
07:22such as age, sex, ethnicity and the composition of the intestinal microbiota.
07:27The latter aspect, in turn, is now particularly investigated.
07:31Very extensive studies have shown, for example,
07:34that among genetically predisposed people to develop diabetes and obesity,
07:38those who follow the Mediterranean diet,
07:40have a significantly lower probability of getting diabetes
07:44than those who follow other types of diets.
07:46The type and quantity of microorganisms
07:49that populate the gastrointestinal tract of each individual
07:52is increasingly involved also as a determining individual factor
07:56of the postprandial glycemic response,
07:58that is, about two hours after eating.
08:01Among patients with type 1 diabetes, insulin-dependent,
08:04for example, those who have a greater abundance of beneficial bacteria and species,
08:09such as Leubacterium Rettale,
08:11show a less marked increase in glycemia
08:14than those who have others.
08:16Experimental studies carried out at the University of Naples Federico II
08:20have recently highlighted how individual characteristics
08:24influence the entity and temporal characteristics
08:27of the increase in postprandial glycemia.
08:30The entity of the oscillations of the glycemia
08:32determines the glycemic variability,
08:34which is in turn a causal agent of the risk of developing cardiovascular diseases,
08:39diabetes itself, and the complications of diabetes
08:42in people at high risk of cardio-metabolic,
08:45that is, with one or more risk factors
08:47between fasting hyperglycemia or postprandial,
08:50overweight or obesity, systolic and diastolic high blood pressure,
08:54dyslipidemia,
08:55researchers have highlighted the role of the genre
08:58in determining the characteristics of the postprandial glycemic response.
09:03Compared to men, women experience, in fact,
09:06a more marked and sudden increase in glycemia,
09:08which suggests that women can benefit more
09:11from a low glycemic index diet,
09:14rich in foods such as legumes, vegetables and whole grains,
09:17which determine less rapid variations of glycemia after meals.
09:21Results that pave the way for increasingly personalized approaches
09:25for nutritional therapy,
09:27insulin therapy management
09:29and diabetes prevention.
09:39This year marks the 30th anniversary
09:41of the first hospital ambulatory service of aesthetic medicine
09:44within a public health environment.
09:46Active, in fact, since March 21, 1994
09:49at the Loro Ospedale Fateberene Fratelli,
09:51Isola Tiberina in Rome,
09:52today Gemelli Hospital, Isola Tiberina,
09:54it has represented a significant step
09:56in the integration of aesthetic medicine
09:58with several other hospital operating units,
10:00thus allowing the application of this medicine
10:02in various pathologies and medical fields.
10:04But what has changed in practice
10:06and what problems are treated in this ambulatory?
10:09We asked Emanuele Bartoletti,
10:11president of the Italian Society of Aesthetic Medicine.
10:13It was an incredible innovation
10:15because back in 1990-1994
10:17aesthetic medicine was still thought of
10:19as an elite medicine,
10:21while the opening of these hospital ambulatories
10:25has determined an approach to aesthetic medicine
10:29of all social strata,
10:31of all ages, in fact.
10:33So they were used, first of all,
10:35to make people understand the importance
10:37of aesthetic medicine in prevention.
10:39And then the incredible thing is that
10:41before we only dealt with healthy skin,
10:43healthy patients.
10:45Now, instead, with the interaction
10:47with the various complex operating units
10:49of the hospital,
10:51with oncology, with radiotherapy,
10:53with dialysis,
10:55rather than with gynecology
10:57and dermatology,
10:59we have realized that many therapies
11:01of aesthetic medicine
11:03can also be useful in these fields.
11:05In particular,
11:07our center was the first center
11:09that started relations
11:11with radiotherapy
11:13and medical oncology
11:15for the management of the care
11:17of oncological patients.
11:19To make cutaneous measurements
11:21and prescribe creams
11:23before the onset of
11:25oncological therapy or radiotherapy,
11:27we realized that it allowed
11:29the patients
11:31we followed
11:33to have a delay
11:35in the appearance
11:37of complications due to chemo
11:39and radiotherapy, cutaneous complications
11:41of course.
11:43And above all, it allowed these patients
11:45to finish
11:47the therapeutic cycles,
11:49while in the unfollowed patients
11:51sometimes they had to stop
11:53due to additional complications.
11:55And this, I must say, has marked
11:57a very important moment
11:59in the reality and social value
12:01of aesthetic medicine.
12:03Then, obviously, these interactions
12:05have expanded to gynecology
12:07with menopause patients,
12:09with all the problems
12:11at the vulvovaginal level
12:13of menopause patients,
12:15or even young patients,
12:17unfortunately, now that they have
12:19a mammary tumor and are sent
12:21for pharmacological menopause
12:23and therefore, unfortunately,
12:25at a young age, they develop
12:27the same problems of menopause women.
12:29And the gynecologists
12:31help them to maintain
12:33a valid quality of life.
12:35Obviously, aesthetic medicine
12:37represents, above all for oncological patients,
12:39also a help
12:41to see
12:43the end of the tunnel,
12:45because they know they can count
12:47on aesthetic medicine to be able
12:49to return to a social normality
12:51as soon as possible.
12:53This, I must say, from a psychological point of view,
12:55turns into
12:57a better ability
12:59to respond also to the cures,
13:01as well as to the psychology of the period
13:03that is definitely difficult for these patients.
13:05An ambulatory, to which
13:07even patients from outside
13:09the nosocomial capitol can turn to.
13:11But who does it in particular?
13:13And for what kind of problems do they ask for help?
13:15It is a heterogeneous group of patients,
13:17more or less of all ages,
13:19who come, here, in the hospital, paradoxically,
13:21the patients are very well
13:23prepared to turn
13:25to the aesthetic doctor,
13:27because they do not come with a request.
13:29Most of our patients are aware
13:31that they will be subjected
13:33to an aesthetic medicine check-up
13:35that will be studied,
13:37and then they will be given
13:39the means and the possibility
13:41to keep what they have of good
13:43and help them to move away
13:45the consequences of aging,
13:47both chronic and photo-induced.
13:49So, I must say that the nosocomial patients
13:51trust us a lot.
13:53Maybe because they know that the aesthetic medicine
13:55that we develop in the hospital is a high-level aesthetic medicine
13:57and that any type of therapy
13:59is always preceded
14:01by a diagnosis made
14:03after a well-structured aesthetic medicine check-up.
14:05Obviously, the ambulatory,
14:07the ambulatory service of aesthetic medicine
14:09in the hospital is not in charge
14:11of the national health service,
14:13but it was born precisely
14:15with the purpose of bringing patients closer
14:17to aesthetic medicine, so the rates
14:19are calculated.
14:21Let's say that they are 20-30%
14:23lower than the rates
14:25that are found
14:27around aesthetic medicine.
14:29So, the hospital
14:31wants to keep
14:33accessible rates
14:35to the widest possible population.
14:37So, I would say that the presence
14:39of the ambulatory service of aesthetic medicine
14:41in the hospital has really represented
14:43a win-win situation
14:45for aesthetic medicine.
14:47It made patients understand
14:49that aesthetic medicine
14:51is useful for them
14:53as a preventive measure
14:55and the preventive measure,
14:57even if it is not expensive,
14:59as long as they teach us
15:01to do it in the right way
15:03and above all in relation to our weaknesses
15:05that need to be known
15:07and above all we need to try
15:09to understand
15:11what life behaviors
15:13and lifestyle should be
15:15so that these weaknesses
15:17can become real
15:19threats for our health.
15:29This was our last news.
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