Publications by authors named "Michael Tirant"

82 Publications

Atypical vascular proliferations of the neck.

Wien Med Wochenschr 2021 Mar 5;171(3-4):57-60. Epub 2020 Aug 5.

Department of Dermatology, Istanbul Medeniyet University, School of Medicine, Istanbul, Turkey.

Atypical vascular proliferations (AVP) are a late complication after radiotherapy. Most cases have been reported in female breast cancer patients on the chest wall. These lesions are mostly of the lymphatic type. Herein, we report a blood vascular-type AVP in a male on the neck 60 years after radiotherapy for a benign hemangioma, which makes this case exceptional. We removed the whole chronic radiodermatitis surgically. Histopathology excluded vascular malignancies but confirmed AVP. We discuss the differential diagnoses and treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s10354-020-00774-xDOI Listing
March 2021

Chemical and mechanical characterization of hyaluronic acid hydrogel cross-linked with polyethylen glycol and its use in dermatology.

Dermatol Ther 2020 07 1;33(4):e13747. Epub 2020 Jul 1.

Department of Dermatology, University of Rome G. Marconi, Rome, Italy.

Hydrogels based on hyaluronic acid are used to restore volume, hydration, and skin tone, as well as to correct scars, asymmetries or defects of the soft tissue. Hyaluronic acid is often chemically crosslinked with different crosslinking agents in order to improve its mechanical and biological properties. Here we focused on defining the chemical and mechanical characterization of a new hydrogel with specific characteristics: hyaluronic acid polyethylene glycol (PEG)-crosslinked with a high concentration of hyaluronic acid (28 mg/mL), manufactured by MatexLab Spa, via Carlo Urbani 2, ang Via Enrico Fermi, Brindisi, Italy. We made a quantitative and qualitative analysis of the content of sodium hyaluronate in the hydrogel after polymerization and sterilization processes and also evaluated histologically the bio integration of these hydrogels in the cutaneous soft tissues. The results suggest that hyaluronic acid hydrogel PEG-crosslinked have great bio integration, great chemical and mechanical properties, compared with other products available on the market, that are cross-linked with different cross-linking agents. The nontoxicity and nonimmunogenicity of PEG guarantee the lack of allergic and immunological reactions. The PEG-crosslinking technology guarantees a high duration time of the implanted hydrogel because of more resistant physiological degradation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13747DOI Listing
July 2020

Favorable effect of creams with skimmed donkey milk encapsulated in nanoliposomes on skin physiology.

Dermatol Ther 2020 07 18;33(4):e13511. Epub 2020 Jun 18.

Department of Pharmacy, Medical Faculty University of Nis, Nis, Serbia.

The use of donkey milk has a long history in external dermal application for cosmetic and medical purposes. The encapsulation of different drugs into nanoliposomes and nutrients may have many benefits for the delivery of the targeted substance. The aim of the present study is to test creams with nanoliposomes encapsulated with skimmed donkey milk, reported in our registered patent, compared with effect of the placebo cream and the untreated skin. To investigate the effect of formulated cream, we have measured the electrical capacitance, transepidermal water loss and the skin pH value. The study included 15 healthy volunteers (11 women and 4 men). The patented creams exhibited satisfactory moisturizing properties very soon after application, while hydration was reached earlier in the spots treated with night cream. Transepidermal water loss slightly decreased only after 4 weeks of treatment in each of the spots assessed. The pH value was similar after each of the treatments. Tested creams may enhance the moisture of skin very soon after application, in this way potentially enable deeper permeation of phospholipids and essential proteins, without changing the pH. It may also contribute to additional anti-aging effects.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13511DOI Listing
July 2020

A new medical imaging technique for diagnosing dermatologic diseases: A clue to treatment choices.

Dermatol Ther 2020 05 2;33(3):e13405. Epub 2020 May 2.

Faculty of Natural Sciences, Mangosuthu University of Technology, Jacobs, South Africa.

Recently, it has been shown that DNA could emit some waves which carry main information about its evolution. Using this idea, we design a new method to image the behavior of skin cells, especially melanocytes, and diagnose their damage. In this method, we make use of a circuit which is formed from DNAs within the damaged melanocytes, a graphene sheet, DNAs within the healthy cells, and a scope. To amplify exchanged waves between hexagonal and pentagonal manifolds of DNAs, we induce some defects in the graphene sheets and replace some hexagonal molecules by pentagonal ones to build a structure similar to the structure of DNAs. We show that unprotected exposure to UVA and UVB damages the DNA in melanocyte cells, producing genetic defects, or mutations, that can lead to exchanged waves between cells and the emergence of a current in our circuit. By analyzing the evolution of this current, we can estimate the rate of destruction in melanocytes, and predict the emergence of cancer.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13405DOI Listing
May 2020

Advanced fractional radiofrequency for the rejuvenation of face, neck, and décolleté.

Dermatol Ther 2020 05 20;33(3):e13402. Epub 2020 Apr 20.

Department of Dermatology, University of Rome G. Marconi, Rome, Italy.

Recently great attention has been paid to the rejuvenation of the face, neck, and décolleté of women with advanced radial fractional radiofrequency. We aimed to clinically evaluate the results obtained with this treatment method. We treated 10 women aged 42 to 62, suffering from skin aging. After carrying out the hydration and sebometry skin tests in each patient, collecting the medical history and taking photographs of the face and décolleté in the standard projections, a questionnaire was submitted to each patient. Finally, we have submitted the patients to one session of application of radiofrequency energy, by an Italian device named "Thuzzle" (GMV, Rome, Italy). The obtained results show a high effectiveness in improving the texture and tone of skin, decreasing micro wrinkles and spot reduction. Advanced radial fractional radiofrequency treatment method shows promising results. Further studies are required to confirm the findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13402DOI Listing
May 2020

Therapeutic and etiologic considerations related to blood group and triggers in psoriasis-A retrospective study.

Dermatol Ther 2020 05 28;33(3):e13401. Epub 2020 Apr 28.

Institute of Dermatological and Regenerative Sciences, Florence, Italy.

The aim of this study was to investigate the relationship between the ABO blood, groups and triggers, including food, of psoriasis. A total of 683 psoriasis patients were included in the retrospective study and divided into groups based on their blood group (ABO). Patients were asked to complete a series questions related to the effect of certain foods and other triggers on their psoriasis symptoms. A significant difference between blood groups and the effect of different triggers on the initiation and exacerbation of psoriasis was noted. Furthermore, similarities in response were found between blood groups sharing the same alleles, such as A and AB, or B and AB. Results from this study suggest a link between blood group type and triggering factors of psoriasis. The data show that different blood groups are significantly more likely to have different initiating and exacerbating triggers for psoriasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13401DOI Listing
May 2020

Remodeling of collagen constituting interlobular septa of subcutaneous adipose tissue following microwaves application.

Dermatol Ther 2020 05 8;33(3):e13362. Epub 2020 Apr 8.

Department of Public Health, Experimental and Forensic Medicine, Unit of Histology and Embryology, University of Pavia, Pavia, Italy.

In this study, the application of a recently introduced device based on electromagnetic energy transfer by microwaves for fat reduction, permitted to study specifically the modifications of thick fibrous collagen interlobular septa in the subcutaneous adipose tissue, related to the formation of large clusters of adipocytes. The use of Picrosirius red staining associated with circularly polarized microscopy gave evidence of appreciable modifications of the fibrous connective tissue forming septa. Compact fibrotic bundles of collagen I forming interlobular septa appeared reduced or dissolved, in part substituted by the increase of more diffuse and finely reticular collagen III. Remodeling of fibrous collagen, which formed bridles involved in the appearance at the surface of the skin of dimpling/orange peer pattern typical of cellulite, was observed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13362DOI Listing
May 2020

New local treatments for different types of melasma: Vascular type vs nonvascular type. A randomized polycentric study.

Dermatol Ther 2020 05 22;33(3):e13300. Epub 2020 Mar 22.

Unit of Dermatology and Regenerative Medicine, G. Marconi University, Rome, Italy.

Melasma is an acquired circumscribed hyperpigmented disorder seen mainly on the malar area of face and other parts of body. We evaluated the safety and efficacy of two different creams for melasma. Sixty volunteers with melasma were evaluated in this study, divided in three groups: A, B, and C. Patients in groups A and B were treated with same creams with the exception of addition of Tranexamic acid in cream B. Patients in group C were treated with placebo cream containing petrolatum only, respectively, twice daily for 10 weeks. Melasma Areas and Severity Index (MASI) score, melanin index (MI) and adverse events were evaluated every 4 weeks. MASI scores declined significantly in groups A and B compared to group C (P < .05). Cream B, containing tranexamic acid, resulted superior to cream A in subjects with hypervascular melasma. No adverse reactions were observed in all groups. Both active creams are safe and effective for melasma and should be selected according to normal or hypervascular type of melasma. Cream B (containing tranexamic acid) should be prescribed instead of cream A (not containing tranexamic acid) to subjects with hypervascular melasma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dth.13300DOI Listing
May 2020

A Mathematical Model for the Signal of Death and Emergence of Mind Out of Brain in Izhikevich Neuron Model.

Open Access Maced J Med Sci 2019 Sep 11;7(18):3121-3126. Epub 2019 Sep 11.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Aim: In this paper, using a mathematical model, we will show that for special exchanged photons, the Hamiltonian of a collection of neurons tends to a constant number and all activities is stopped. These photons could be called as the dead photons. To this aim, we use concepts of Bio-BIon in Izhikevich Neuron model.

Methods: In a neuron, there is a page of Dendrite, a page of axon's terminals and a tube of Schwann cells, axon and Myelin Sheath that connects them. These two pages and tube form a Bio-Bion. In a Bio-Bion, exchanging photons and some charged particles between terminals of dendrite and terminals of axon leads to the oscillation of neurons and transferring information. This Bion produces the Hamiltonian, wave equation and action potential of Izhikevich Neuron model. Also, this Bion determines the type of dependency of parameters of Izhikevich model on temperature and frequency and obtains the exact shape of membrane capacitance, resting membrane potential and instantaneous threshold potential.

Results: Under some conditions, waves of neurons in this BIon join to each other and potential shrinks to a delta function. Consequently, total Hamiltonian of the system tends to a constant number and system of neuron act like a dead system. Finally, this model indicates that all neurons have the ability to produce similar waves and signals like waves of the mind.

Conclusion: Generalizing this to biology, we can claim that neurons out of the brain can produce signals of minding and imaging and thus mind isn't confined to the brain.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.774DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910805PMC
September 2019

Psychotherapy Role in Treatment of Chronic Spontaneous Urticaria in a 32 Years Old Female Patient.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3118-3120. Epub 2019 Aug 30.

Department of Dermatology, University of G. Marconi, Rome, Italy.

As indicated by the latest scientific evidence, the lines between different fields of medicine gradually blur and overlap more and more. Psychiatry and dermatology have seen this trend in the last decade as an ever-increasing number of studies suggest the strong connection of many dermatological syndromes and diseases with psychiatric conditions and vice versa. It seems that the relationship is more intertwined than previously believed and the effects of different multidisciplinary approaches to diagnostic and treatment are being considered. The aim of this case report is to highlight the effect of psychotherapy on chronic spontaneous urticaria which is tightly related to the maladaptive stress response.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.773DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910793PMC
September 2019

Formation of Neural Circuits in an Expanded Version of Darwin's Theory: Effects of DNAs in Extra Dimensions and within the Earth's Core on Neural Networks.

Open Access Maced J Med Sci 2019 Sep 10;7(18):3113-3117. Epub 2019 Sep 10.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Aim: In this paper, inspiring Darwin's theory, we propose a model which connects evolutions of neural circuits with evolutions of cosmos. In this model, in the beginning, there are some closed strings which decay into two groups of open strings.

Methods: First group couple to our universe from one side and produce matters like some genes of DNAs and couple to an anti-universe from another side with opposite sign and create anti-matters like some anti-genes of anti-DNAs. Second group couple to the star and planet's cores like the earth's core from one side and produce anti-matters like stringy black anti-DNA and couple to outer layers of stars and planets like the earth from other side and produce matters like some genes of DNAs on the earth. Each DNA or anti-DNA contains some genetic circuits which act like the circuits of receiver or sender of radio waves. To transfer waves of these circuits, some neurons emerge which some of them are related to genetic circuits of anti-DNAs in anti-universe, and some are related to genetic circuits of stringy black anti-DNA within the earth's core. A collection of these neural circuits forms the little brain on the heart at first and main brain after some time.

Results: To examine the model, we remove effects of matters in outer layers of earth in the conditions of microgravity and consider radiated signals of neural circuits in a chick embryo. We observe that in microgravity, more signals are emitted by neural circuits respect to normal conditions. This is a signature of exchanged waves between neural circuits and structures within the earth's core.

Conclusion: These communications help some animals to predict the time and place of an earthquake.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.769DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910808PMC
September 2019

Beta Blockers and Melanoma.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3110-3112. Epub 2019 Aug 30.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Understanding the mechanisms of cancer immune-tolerance is one of the most important challenges. Several studies have demonstrated the potential anticarcinogenic effects of beta-blockers, in patients with prostate cancer, breast cancer, and melanoma. At the other side variety of dermatoses may be caused or aggravated by β-blockers-psoriasis, lichen planus-like drug eruptions (LDE), acrocyanosis, alopecia etc. Beta-blockers have been shown to improve the prognosis of melanoma patients significantly. Propranolol inhibits melanoma by downregulating the tumour angiogenesis but also tumour cell proliferation, invasiveness and local immune suppression. Studies showed that only β3-but, not β2-adrenoceptors, were up-regulated under hypoxia in peripheral blood mononuclear cells and selectively expressed in immune cell sub-populations including Treg, MDSC, and NK. They increased NK and CD8 number and cytotoxicity. Catecholamines may retard melanoma progression and that β-blockers may have unrecognised potential as a therapeutic intervention for melanoma, in the prevention of the growth of melanoma in all stages and as adjuvant therapy with other targeted and immune therapies for melanoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910815PMC
September 2019

In Ovo Sexing of Chicken Eggs by Virus Spectroscopy.

Open Access Maced J Med Sci 2019 Sep 12;7(18):3106-3109. Epub 2019 Sep 12.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Recently, some new methods for sexing of chicken eggs by fluorescence and Raman spectroscopy through the shell membrane have been proposed. On the other hand, in another investigation, a new virus medical imaging has been suggested. In this research, summing over these considerations, a new technique for sexing of chicken eggs by virus spectroscopy through the shell membrane is proposed. It is shown that viruses outside the shell of egg can communicate with materials inside it and determine the gender of chick embryo and it's evolutions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.768DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910803PMC
September 2019

The Effects of Magnesium - Melatonin - Vit B Complex Supplementation in Treatment of Insomnia.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3101-3105. Epub 2019 Aug 30.

Department of Dermatology, G. Marconi University, Rome, Italy.

Insomnia means difficulty in falling asleep and/or stays asleep. Insomnia commonly leads to daytime sleepiness, lethargy, and a general feeling of being unwell. The most common treatment of insomnia includes GABAA receptor positive allosteric modulators or Melatonin agonists. Our study aimed to evaluate the efficacy of Magnesium- melatonin-vitamin B complex supplement in the treatment of insomnia. The study included 60 patients diagnosed with insomnia. The patients were randomly divided into study group (N = 30), and control group (N = 30), and study group was treated with Magnesium-melatonin-vitamin B complex (one dose contains 175 mg liposomal magnesium oxide, 10 mg Vit B6, 16 μg vit B12, melatonin 1 mg, Extrafolate-S 600 μg) once a day 1 hour before sleep, during the 3 months. The severity of insomnia symptoms was measured by self-reported Athens insomnia scale (AIS), with a cut-off score by Soldatos (AIS score ≥ 6). Mean AIS score at zero points was 14.93 ± 3.778 in the study group and 14.37 ± 4.081 in the control group (p = 0.476), indicating the compatibility of the groups, and both scores correspond to mild to moderate insomnia. Mean AIS score after 3 months of the Magnesium- melatonin- vitamin B complex supplementation was 10.50 ± 4.21 corresponding to mild insomnia, while median AIS score in the control group was 15.13 ± 3.76 which is referred to moderate insomnia, and difference among groups was significant (p = 0.000). Our founding's indicating that 3 months of the Magnesium- melatonin-vitamin B complex supplementation has a beneficial effect in the treatment of insomnia regardless of cause.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.771DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910806PMC
September 2019

DNA Waves and Their Applications in Biology.

Open Access Maced J Med Sci 2019 Sep 11;7(18):3096-3100. Epub 2019 Sep 11.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Aim: In this research, we show that DNA waves have many applications in biology. DNA is formed by the joining of quantum particles like electrons and charged atoms. DNA has different motions during transcription, translation, and replication, in which the charged particles move, accelerate, and emit waves. Thus, DNA could emit quantum waves.

Methods: Two methods are proposed to observe the effect of DNA waves. The first proposed method measures DNA waves emitted by bacteria suspended in the milk. The vessel of milk is placed in the interior of an inductor. One side of the vessel is connected to a generator and another side to a scope. By sending a current to the inductor, an input electromagnetic field is produced. Bacteria interact with the input field, change it and produce new output signals. Using the scope, the output signals are observed and compared with the input signals. The number of DNA waves produced also depends on temperature.

Results: At lower temperatures, bacterial replication is less, and fewer DNA waves are produced. Conversely, more bacteria are generated at higher temperatures, and more DNA waves are produced. The second proposed method acquires and images of DNA signals of chick embryos. In this method, a circuit is constructed that consists of a graphene or metal tube, generator, inductor, scope, DNA in the interior of eggs and DNA exterior to the eggs. Magnetic waves pass the interior and exterior DNA as well as the graphene. The DNA is excited and the exciting interior/exterior DNA exchanges waves. Some of these waves interact with electrons in the graphene tube, and a current is generated. Properties of the chick embryo DNA can be explored by analysing changes in the waves that emerge from the eggs.

Conclusion: It is concluded that DNA waves could be used extensively in imaging and provide for us the exact information about evolutions of DNAs interior of biological systems.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.767DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910796PMC
September 2019

New Trends in Cutaneous Melanoma Surgery.

Open Access Maced J Med Sci 2019 Sep 14;7(18):3090-3092. Epub 2019 Sep 14.

Department of Dermatology, University of G. Marconi, Rome, Italy.

The main surgical treatment for melanoma consists in wide surgical excision of the primary lesion and the sentinel node but in recent times management of melanoma is rapidly evolving with the introduction of new systemic therapies, like BRAF inhibitors, MEK inhibitors and antibodies anti-PD-1 that show good results in controlling even advanced stages of the disease. This review aims to present data for the optimal surgical management of patients with malignant melanoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910799PMC
September 2019

Recovery of Brain in Chick Embryos by Growing Second Heart and Brain.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3085-3089. Epub 2019 Aug 30.

Department of Dermatology, University of G. Marconi, Rome, Italy.

To recover chick embryos damaged the brain, two methods are presented. In both of them, somatic cells of an embryo introduced into an egg cell and an embryo have emerged. In one method, injured a part of the brain in the head of an embryo is replaced with a healthy part of the brain. In the second method, the heart of brain embryo dead is transplanted with the embryo heart. In this mechanism, new blood cells are emerged in the bone marrow and transmit information of transplantation to subventricular zone (SVZ) of the brain through the circulatory system. Then, SVZ produces new neural stem cells by a subsequent dividing into neurons. These neurons produce new neural circuits within the brain and recover the injured brain. To examine the model, two hearts of two embryos are connected, and their effects on neural circuits are observed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910787PMC
September 2019

A Black Hole at the Center of Earth Plays the Role of the Biggest System of Telecommunication for Connecting DNAs, Dark DNAs and Molecules of Water on 4+N- Dimensional Manifold.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3073-3080. Epub 2019 Aug 30.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Recently, some scientists from NASA have claimed that there may be a black hole like structure at the centre of the earth. We show that the existence of life on the earth may be a reason that this black hole like object is a black brane that has been formed from biological materials like DNA. Size of this DNA black brane is 109 times longer than the size of the earth's core and compacted interior it. By compacting this long object, a curved space-time emerges, and some properties of black holes emerge. This structure is the main cause of the emergence of the large temperature of the core, magnetic field around the earth and gravitational field for moving around the sun. Also, this structure produces some waves which act like topoisomerase in biology and read the information on DNAs. However, on the four-dimensional manifold, DNAs are contracted at least four times around various axis's and waves of earth couldn't read their information. While, by adding extra dimensions on 4 +n-dimensional manifold, the separation distance between particles increases and all of the information could be recovered by waves. For this reason, each DNA has two parts which one can be seen on the four-dimensional universe, and another one has existed in extra dimensions, and only it's e_ects is observed. This dark part of DNA called as a dark DNA in an extra dimension. These dark DNAs not only exchange information with DNAs but also are connected with some of the molecules of water and helps them to store information and have memory. Thus, the earth is the biggest system of telecommunication which connects DNAs, dark DNAs and molecules of water.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910781PMC
September 2019

Clinical Applications of System Regulation Medicine.

Open Access Maced J Med Sci 2019 Sep 14;7(18):3053-3060. Epub 2019 Sep 14.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Increasing incidence and poor outcome of chronic non-communicable diseases in western population would require a paradigm shift in the treatments. Guidelines-based medical approaches continue to be the standard rule in clinical practice, although only less than 15% of them are based on high-quality research. For each person who benefits from the 10 best-selling drugs in the USA, a number between 4 and 25 has no one beneficial effect. The reductionist linear medicine method does not offer solutions in the non-manifest preclinical stage of the disease when it would still be possible to reverse the pathological progression and the axiom "a drug, a target, a symptom" are still inconclusive. Needs additional tools to address these challenges. System Medicine considers the disease as a dysregulation of the biological networks that changes throughout the evolution of the pathological process and with the comorbidities development. The strength of the networks indicates their ability to withstand dysregulations during the perturbation phases, returning to the state of stability. The treatment of dysregulated networks before the symptomatological manifestation emerges offers the possibility of treating and preventing pathologies in the preclinical phase and potentially reversing the pathological process, stopping it or preventing comorbidities. Furthermore, treating shared networks instead of individual phenotypic symptoms can reduce drug use, offering a solution to the problem of ineffective drug use.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.775DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910802PMC
September 2019

Melanoma and Mastocytosis.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3050-3052. Epub 2019 Aug 30.

Department of Dermatology, Guglielmo Marconi University, Rome, Italy.

There are numerous cases reports and studies confirming the enhanced incidence of melanoma among patients with mastocytosis, especially with systemic mastocytosis. These two diseases are arising from two different types of cells; melanoma arises from neural crest cells and mastocytosis from hematopoietic stem cells. But there are a lot of similarities between the two diseases. The most important and significant is the dependence of the growth factor receptor c-KIT and c-KIT ligand (stem cell factor) for their growth and development. Also, expression of the STAT3 (signal transducer and activator of transcription 3) and transcription factors MITF (microphthalmia-associated transcription factor) make the connection between melanoma and mastocytosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.772DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910818PMC
September 2019

Psychological Impact of Melanoma, How to Detect, Support and Help.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3043-3045. Epub 2019 Aug 30.

Department of Nuclear Physics, Sub-nuclear and Radiation, G. Marconi University, Rome, Italy.

Incidence of melanoma is increasing every year. A few years ago, we could not speak about long term survivors with melanoma. Chemotherapy did not give a good effect in the past. Metastasis occurred very rapidly, and the progression of melanoma was very fast. But now, with new forms of therapy, especially immunotherapy and target therapy, for the first time, we have long-time survivors. For the prognosis of melanoma, the most important is the stage in which melanoma is detected. For all dermatologists, it is very important to be aware of the psychological impact of melanoma on patients. Dermatologists should recognise psychological disorders. Several different scales can be used for the detection of depression and anxiety - some of them are completed by researchers, some of them are completed by patients, and also, we have combined scales. The need for adequate social and family support as well as psychological help to achieve better coping with illness is necessary. Learning techniques to overcome fear and stress would help in better functioning of all affected, regardless of the stage of the disease. The most severe cases of anxiety and depression, in addition to psychotherapeutic interventions, should also be considered medication therapy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.770DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910785PMC
September 2019

Gut Microbiota and the Alteration of Immune Balance in Skin Diseases: From Nutraceuticals to Fecal Transplantation.

Open Access Maced J Med Sci 2019 Sep 12;7(18):3034-3038. Epub 2019 Sep 12.

Department of Dermatology, G. Marconi University, Rome, Italy.

The P.N.E.I. (Psycho-Neuro-Endocrine-Immunology) approach is represented by the interdisciplinary concept of bidirectional cross-talk between the psycho-neuro-endocrine and immune systems, which can influence the immune response. The well-known Gut-Brain Axis and the Gut-Skin Axis can be merged in a bigger network- the Gut-Brain-Skin Axis, with complex regulation by cytokines, neuro-peptides, neuro-hormones and another messenger (signalling) molecules and maybe the most important modulator of the Gut-Brain-Skin Axis/ the gut microbiota. The role of gut bacterial homeostasis is very important, and the homeostatic imbalance of the immune response may be a relevant etiologic/pathophysiologic factor for extra-intestinal and intestinal inflammatory, allergic and autoimmune diseases. The Low Dose Cytokines Medicine (LDM) is an innovative therapeutic approach. It is based on the most advanced knowledge in molecular biology and low dose pharmacology with the primary outcome. The SKA (Sequential Kinetic Activation) technology, codified and standardised by GUNA S.p.a. -Italy- makes the low doses of signalling molecules able to be active even below the minimum dose classically considered as effective and the significative efficacy of orally administered low-dose signalling molecules is the most representative aspect of LDM. The Physiologic Nutraceuticals and the Low Dose Medicine are two of the most promising approaches for the treatment of skin diseases based on the rebalance of the immune response and the recovery of gut dysbiosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.827DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910798PMC
September 2019

Treatment of Psoriasis: Novel Approaches to Topical Delivery.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3018-3025. Epub 2019 Aug 30.

Department of Dermatology, University of Rome "G. Marconi", Rome, Italy.

Topical treatment is the cornerstone for the management of mild to moderate psoriasis. Despite efforts in drug development, patient's satisfaction with the available topical treatments is limited. A strategy to improve safety, efficacy and comfort of topical treatment provides the development of new drug delivery and drug carrier systems. This review provides an overview of recent advances in this field with a focus on psoriasis. Laser-assisted drug delivery, foam formulations, nanoparticles, ethosomes, and niomes are considered. Hopefully, these new developments will improve topical drug therapy and patient satisfaction.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910788PMC
September 2019

Unilateral Pseudo-Ainhum in Liver Cirrhosis.

Open Access Maced J Med Sci 2019 Sep 10;7(18):3013-3014. Epub 2019 Sep 10.

Department of Dermatology, University of Rome "G. Marconi", Rome, Italy.

Background: Pseudo-ainhum is defined as any case of auto-amputation not associated with the classic spontaneous ainhum seen in Africans with unknown etiology.

Case Presentation: A severely ill 58-year-old male patient presented with a painless constricting circular band on his left second toe. His medical history was remarkable for severe alcoholic liver cirrhosis with ascites formation leading to dyspnea. He had a hypoalbuminemia and a pronounced peripheral sensory neuropathy.

Conclusion: Here we present the second case of pseudo-ainhum associated with liver cirrhosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.681DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910809PMC
September 2019

Wells Syndrome - An Odyssey.

Open Access Maced J Med Sci 2019 Sep 30;7(18):3002-3005. Epub 2019 Jun 30.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.

Background: Wells syndrome is a rare idiopathic dermatosis of the eosinophilic spectrum. Diagnostic criteria include cutaneous eruptions of variable morphology with eosinophilic infiltrates, peripheral blood eosinophilia, a relapsing, remitting course, and exclusion of systemic disease. Diagnosis is often delayed.

Case Presentation: We present a 28-year older man with recently developed pruritic and sometimes painful erythema. His medical history was positive for coughing in the evening that started in November 2012. Later, a pansinusitis developed. Early diagnosis improves the outcome.

Conclusion: Standardized treatment has yet to be developed. In our case, systemic corticosteroids were of limited value only.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.572DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910816PMC
September 2019

New System Delivering Microwaves Energy for Inducing Subcutaneous Fat Reduction: In - Vivo Histological and Ultrastructural Evidence.

Open Access Maced J Med Sci 2019 Sep 30;7(18):2991-2997. Epub 2019 Aug 30.

Clinic for Psychiatric Disorders "Dr. Laza Lazarevic", Belgrade, Serbia.

Background: Recently, it has been developed a new technology for the reduction of subcutaneous adipose tissue through a non-invasive treatment by microwaves. The main objective of the present study is to demonstrate the feasibility of utilising a non-invasive, localised microwaves (MW) device to induce thermal modifications into subcutaneous adipose tissue only by a controlled electromagnetic field that heats up fat preferentially. This device is provided with a special handpiece appropriately cooled, directly contacting the cutaneous surface of the body, which provides a calibrated energy transfer by microwaves.

Aim: In this paper, microscopic and ultrastructural modifications of subcutaneous adipose tissue induced by microwaves irradiation are evaluated.

Methods: Our experimental plan was designed for collecting biopsy samples, for each skin region treated with a single irradiation session, 1) before treatment (control), 2) immediately after treatment, 3) after 6 hrs, 4) after 1 month, 5) after 2 months. Bioptic samples from each step were processed for light microscopy and transmission electron microscopy. At the same time, each region where biopsies were collected was subjected to ultrasound examination. Recorded images permitted to evaluate the thickness of different layers as epidermis, dermis, hypodermis, connective fasciae, until to muscle layer, and related modifications induced by treatment.

Results: In every biopsy collected at different time-steps, epidermis and superficial dermis appeared not modified compared to control. Differently, already in the short-term biopsies, in the deep dermis and superficial hypodermis, fibrillar connective tissue appeared modified, showing reduction and fragmentation of interlobular collagen septa. The most important adipose tissue modifications were detectable following 1 month from treatment, with a significant reduction of subcutaneous fat, participating both the lysis of many adipocytes and the related phagocytic action of monocytes/macrophages on residuals of compromised structures of adipocytes. In the samples collected two months following treatment, the remnants of adipose tissue appeared normal, and macrophages were completely absent.

Conclusions: Ultrasound, microscopic and ultrastructural evidence are supporting significant effectiveness of the new device treatment in the reduction of subcutaneous fat. In this paper, the possible mechanisms involved in the activation of the monocytes/macrophages system responsible for the removal of adipocytes residuals have also been discussed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.778DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910790PMC
September 2019

A Painful Step - Pendulating Plantar Eccrine Poroma.

Open Access Maced J Med Sci 2019 Sep 31;7(18):2988-2990. Epub 2019 May 31.

Department of Dermatology, University of Rome "G. Marconi", Rome, Italy.

Background: Eccrine poroma is a benign tumour of eccrine duct epithelium. The usual clinical presentation is nodular.

Case Report: We present a 78-year-old man with a painful pendulating flesh-coloured malodorous plantar tumour. Differential diagnoses included telangiectatic granuloma, acrochordon, basal cell or squamous cell carcinoma, cylindroma, amelanotic melanoma, and verruca. Microbiological investigations identified numerous bacteria including Corynebacterium striatum, Streptococcus dysgalactiae, Staphylococcus aureus, Citrobacter koseri. We performed surgery since the tumour hampered his mobility. Histopathology revealed a well-circumscribed tumour composed of cuboidal cells with eosinophilic cytoplasm. Healing was unremarkable.

Conclusions: Pendulating plantar eccrine poroma is a rare clinical presentation of this benign adnexal tumour. Often asymptomatic, in some cases the tumour may become painful. Because of the bacterial colonisation, it could lead to deep soft tissue infections. Malignant transformation is possible. Surgical removal is the treatment of choice.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910794PMC
September 2019

Botulin Toxin Use in Rosacea and Facial Flushing Treatment.

Open Access Maced J Med Sci 2019 Sep 30;7(18):2985-2987. Epub 2019 Aug 30.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Botulinum toxin (BTX) is a neurotoxin derived from the Clostridium botulinum bacterium that inhibits the release of acetylcholine at the neuromuscular junction level whose effects has been used for many years to treat a variety of muscular/neuromuscular conditions and more recently also for cosmetic use. BTX has experimented in some dermatological conditions, which include Rosacea and facial flushing treatment with good results. The complex mechanism underlying those results is not completely understood but was proposed a release inhibition of acetylcholine from peripheral autonomic nerves of the cutaneous vasodilatory system combined with the blockade substance P and calcitonin gene-related peptide (CGRP) thus modulating blood vessel dilatation. We analysed the published data on BTX off label applications rosacea and flushing retrieved from PubMed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.784DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910814PMC
September 2019

Botulin Toxin Use in Scars/Keloids Treatment.

Open Access Maced J Med Sci 2019 Sep 30;7(18):2979-2981. Epub 2019 Aug 30.

Department of Dermatology, University of G. Marconi, Rome, Italy.

Botulinum toxin (BTX) is a neurotoxin protein derived from the Clostridium botulinum bacterium that inhibits the release of acetylcholine at the neuromuscular junction level whose effects has been used for many years to treat a variety of muscular/neuromuscular conditions and more recently also for cosmetic use. BTX has experimented in some dermatological conditions which include scar prevention and treatment with good results The complex mechanism underlying those results is not completely understood but several mechanisms were proposed release inhibition of different substances like (TGF)-β, substance P, calcitonin gene-related peptide (CGRP) and glutamate thus modulating cutaneous inflammation and wound healing. We analysed the published data on BTX off label applications on scars and keloids retrieved from PubMed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.783DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910812PMC
September 2019

Immunocompromised Districts of Skin: A Case Series and a Literature Review.

Open Access Maced J Med Sci 2019 Sep 10;7(18):2969-2975. Epub 2019 Sep 10.

Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany.

Background: The concept of immunocompromised districts of skin has been developed by Ruocco and helps to explain certain aspects of the macromorphology of skin diseases. This concept unites the isomorphic response of Koebner and the isotopic response of Wolf.

Case Reports: We present different cutaneous conditions which can lead to immunocompromised districts of skin such as scars, radiodermatitis, lymphedema, disturbed innervation or mechanical friction etc. Typical and rarer skin disorders associated with them are discussed and illustrated by their observations.

Conclusion: At this moment, we wish to inform dermatologists and non-dermatologists about Ruocco's concept and its implications.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3889/oamjms.2019.680DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910813PMC
September 2019