Antonio Scarano1 · E. Qorri2 · A. Sbarbati3 · S. A. Gehrke4 · Alessio Frisone1 · D. Amuso3 · Sergio Rexhep Tari1
Received: 30 March 2024 / Accepted: 17 May 2024 / Published online: 24 June 2024
© The Author(s) 2024
Antonio Scarano
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E. Qorri
A. Sbarbati
S. A. Gehrke
D. Amuso
Sergio Rexhep Tari
1 Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Strada Marcello Mucci 38/B, 66100 Chieti, Italy
2 Department of Dentistry, Faculty of Medical Sciences, Albanian University, 1001 Tirana, Albania
3 Department of Neurosciences, Biomedicine and Movement Sciences, Anatomy and Histology Section, School of Medicine, University of Verona, Verona, Italy
4 Department of Research, Bioface/PgO/UCAM, Montevideo, Uruguay
Abstract
Background Various techniques have been employed in aesthetic medicine to combat skin aging, in particular that of the facial region. Hyaluronic acid is utilized to enhance moisture levels and extracellular matrix molecules. This study aims to histologically assess the efects of low molecular weight hyaluronic acid fragments combined with amino acids (HAAM) on facial skin rejuvenation through intradermal microinjections.
Methods A total of twenty women, with an average age of 45 and ranging from 35 to 64 years old, participated in the study, including 8 in menopause and 12 in the childbearing age group. Mesotherapy was used to administer HAAM to the patients. Prior to and three months after the treatment, each patient underwent small circular punch biopsies. Ultrasound examinations were conducted using B-mode, capturing 2D images in longitudinal or transverse orientations with frequencies ranging from 5 to 13 Mega-hertz (MY LAB X8, ESAOTE, Genova, Italy). A total of 60 ultrasound examinations were taken, with 30 collected before treatment and 30 after treatment.
Results The histological analysis demonstrates an increase in fbroblast activity resulting in the production of Type III reticular collagen, as well as an increased number of blood vessels and epidermal thickness. However, the analysis of ultrasound data before and after treatment showed no statistical diference in skin thickness in malar area, chin and mandibular angle.
Conclusions Histological assessments indicate that subcutaneous infltration of HAAM has a substantial impact on the dermis of facial skin.
Keywords Hyaluronic acid · Hyaluronic acid fragments · Amino acid · Fibroblast · Skin aging · Ultrasound
Jefferson L. Triozzi, MD, MSCI; Zhihong Yu, MS, PhD; Ayush Giri, MS, PhD; Hua-Chang Chen, PhD; Otis D. Wilson, BBA; Brian Ferolito, MS; T. Alp Ikizler, MD; Elvis A. Akwo, MD, MS; Cassianne Robinson-Cohen, PhD; John Michael Gaziano, MD, MPH; Kelly Cho, PhD, MPH; Lawrence S. Phillips, MD; Ran Tao, PhD; Alexandre C. Pereira, MD, PhD; Adriana M. Hung, MD, MPH; for the VA Million Veteran Program
Key Points
Question Are glucagon-like peptide 1 receptor agonists (GLP-1RAs) associated with kidney disease progression?
Findings In this genetic association study of 353 153 adults, higher genetic GLP1R gene expression as a proxy for GLP-1RAs was associated with a small reduction in the risk of kidney disease progression, even after adjusting for obesity and diabetes.
Meaning These findings support a nephroprotective role of GLP-1RAs.
IMPORTANCE Glucagon-like peptide 1 receptor agonists (GLP-1RAs) may have nephroprotective properties beyond those related to weight loss and glycemic control.
OBJECTIVE To investigate the association of genetically proxied GLP-1RAs with kidney disease
DESIGN, SETTING, AND PARTICIPANTS This genetic association study assembled a national retrospective cohort of veterans aged 18 years or older from the US Department of Veterans Affairs Million Veteran Program between January 10, 2011, and December 31, 2021. Data were analyzed from November 2023 to February 2024.
EXPOSURES Genetic risk score for systemic GLP1R gene expression that was calculated for each study participant based on genetic variants associated with GLP1R mRNA levels across all tissue samples within the Genotype-Tissue Expression project.
MAIN OUTCOMES AND MEASURES The primary composite outcome was incident end-stage kidney disease or a 40% decline in estimated glomerular filtration rate. Cox proportional hazards regression survival analysis assessed the association between genetically proxied GLP-1RAs and kidney disease progression.
RESULTS Among 353 153 individuals (92.5% men), median age was 66 years (IQR, 58.0-72.0 years) and median follow-up was 5.1 years (IQR, 3.1-7.2 years). Overall, 25.7% had diabetes, and 45.0% had obesity. A total of 4.6% experienced kidney disease progression. Overall, higher genetic GLP1R gene expression was associated with a lower risk of kidney disease progression in the unadjusted model (hazard ratio [HR], 0.96; 95% CI, 0.92-0.99; P = .02) and in the fully adjusted model accounting for baseline patient characteristics, body mass index, and the presence or absence of diabetes (HR, 0.96; 95% CI, 0.92-1.00; P = .04). The results were similar in sensitivity analyses stratified by diabetes or obesity status.
CONCLUSIONS AND RELEVANCE In this genetic association study, higher GLP1R gene expression was associated with a small reduction in risk of kidney disease progression. These findings support pleiotropic nephroprotective mechanisms of GLP-1RAs independent of their effects on body weight and glycemic control.
原创： 十六点五 中山二院糖尿病足中心
糖尿病足的预防是各种指南中最重要的部分，无论是国内还是国外的，在各版的IWGDF指南都是重要内容，而且说明得特别详细及有比较多得循证医学的证据支持。但比较几个版本的IWGDF指南及国内外其他指南，这部分是肯定存在的，从中可以看出“糖尿病足的预防”已经深入人心。
糖尿病足实质上就是一种糖尿病人足部出现难以愈合的皮肤慢性溃疡，如何使糖尿病人足部皮肤慢性溃疡愈合是糖尿病足治疗的中心，因此，围绕足部皮肤慢性溃疡愈合是糖尿病足治疗的中心环节。
IWGDF（The International Working Group on the Diabetic Foot）是一个以欧美从事糖尿病足工作的专家为主的，有其他大洲有关专家共同组成的，目前国际上有关糖尿病足的预防、诊断、治疗、研究、管理等方面最专业的国际组织之一（基本上没有之一）。
脓腔切开，3型安尔碘纱布填塞一天之后，重新打开伤口，进行第二次清创，这次清创也是非常重要的。一般需要完成三个任务：探查创面、鉴别坏死及感染的组织、仔细清除各种需要清除的组织。
（3）要把足部被细菌侵袭的各个空隙最好都能打开，尤其是足部比较重要的“空隙”，也是为了引流充分。
糖尿病足的创面清创术是最有效的局部抗菌治疗。毛主席很早之前就教导我们：扫把不到灰尘照例不会自己跑掉，糖尿病足清创术就是治疗糖尿病足局部创面上的“灰尘”（细菌）最有效的“扫把”。
伤口世界平台生态圈，以“关爱人间所有伤口患者”为愿景，连接、整合和拓展线上和线下的管理慢性伤口的资源，倡导远程、就近和居家管理慢性伤口，解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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