Salus tv n. 35 del 28 agosto 2024

adnkronos

(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”

Transcript

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.

15:31To contact us,

15:33you can write to

15:35salute-adnkronos.com

15:37Thank you for following us

15:39and see you next time!

15:47www.adnkronos.com

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