REVISTA MEDICALA

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EMC

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anul 3, nr.8, aprilie 2008

rd3 INTERNATIONAL CONGRESSOF ANTI-AGING MEDICINE

st1 INTERNATIONAL CONGRESS FOR LASERS IN MEDICINE AND SURGERY

2 - 4 MAI, BUCHAREST, ROMANIA National Institute of Statistics

MEDICINA ANTI - AGING(PREVENTIE, LONGEVITATE SI CALITATEA VIETII)

DERMATOLOGIE COSMETICA &LASERE IN MEDICINA SI CHIRURGIE

3

Today we are able to travel to the inner sanctuary of the cell, well into the amino acid structure of the DNA. The speed of such discovery means that the many of our traditional understand on health issues need constant revision and updating.At the dawn of the third millennium medicine became a highly sophisticated and technologically dependent science. Lasers took the lead of that technological revolution and through use cover almost all-medical specialties including anti- aging and preventive medicine.On behalf of the Executive Committee of this event, I would like to invite you to participate at the 3rd International Congress of Anti-aging Medicine and 1st International Congress on Lasers in medicine and Surgery to be held between 2nd -4th of May at National Institute of Statistics, Bucharest Romania.This Congress will give us the opportunity to re-evaluate Laser Therapy and Laser Surgery aplications in Anti-Aging Medicine and predict it's future and at the same time will bring you up-to-date on the current Anti-aging medicine and uses of lasers.I am certain that the debating of issues and exchange of information and opinions by some of the world's leading experts in the fast-expanding and exciting field of laser and anti-aging medicine will stimulate new levels of international cooperation, as well as promote further research across a wide range of topics. As there will be many participants, I anticipate that a far greater degree of information exchange will be possible. I extend a warm welcome to all, and hope that you will take advantage of this opportunityYou will alsow have the oportunity to visit the second largest building in the world The House Of Parliament, located close to our Congress site and the new and old city of Bucharest.We look forward to welcoming you in Bucharest, Romania and we are certain that your participation will greatly contribute to the success of the event.

Yours sincerely,The Congress Organizing Committe

President's GreetingDear Colleagues and Friends, Not so long ago, the term medical anti aging knowledge was a bit of a misnomer. The medical community regarded aging as an evitable part of human life, and didn't devote much time to figuring out how to slow it down or alter its effects. Those with money could have plastic surgery, but that was about all. Today however, scientific research is revealing many of the processes that cause physical aging as the years pass, and with that understanding comes the opportunity to tinker with and try to ameliorate the aging process.The timing is perfect: the baby boomers, a huge cohort of affluent educated North Americans and Europeans are moving into their senior years and they want medical anti aging resources. The baby boomers have grown up in good health, with readily available medical care and the belief that every disease can be cured. They believe that medical treatment can keep them feeling young and vigorous as well, while they enjoy retirement. They may be right.Many professionals with medical training are now involved in researching possible approaches to anti-aging medicine. We're learning that many common diseases of old age can be avoided by eating, or not eating, certain foods, keeping our bodies fit, and protecting ourselves from environmental threats. We're identifying genes that predispose people to certain diseases, which allows us to identify and possibly treat those at risk. We are discovering many new drugs in chemistry and nature that help to fight diseases already in progress. And we're discovering that some foods have potent healthful properties that we never imagined were there. Surgical and dermatological interventions are still available as well, and they are better than ever.Whatever you choose, keep your eye on the latest in medical breakthroughs - there are lots of products and services already available that really do help you look and feel younger, and maintain better health. It's a safe bet there will be many more to choose from in the near future, as anti-aging medicine gets more and more advanced.Advances in technology and research has usher in a new era of medical information that only a generation ago was unheard of. It is not too long ago when our exploration of the human body is limited to the organ and its gross pathology.

rd3 International Congressof Anti-Aging Medicine

st1 International Congressfor Lasers in Medicine and Surgery



4

SUMARSUMAR

IQ MEDICAL MEDIAANUL II nr. 5, iunie 2007

EDITOR COORDONATOR CÅTÅLIN ENÅ[email protected]

DIRECTOR EXECUTIVBOGDAN DIMITRIE [email protected]

COMITET EDITORIALPREÇEDINTEROBERT GOLDMAN - SUA

RONALD KLATZ - SUAMICHAEL KLENTZE - GermaniaCATHERINE DECUYPER - FrantaCHRISTOPHE DE JAEGER - FrantaCALIN GIURCANEANU - RomâniaOTHON PAPADOPOULOS - GreciaVIRGIL FEIER - RomâniaJOHN IONESCU - GermaniaALEXANDRU TATARU - RomâniaRADU RADULESCU - RomâniaGEORGIANA OZANA TACHE - RomâniaDANIEL GRIGORE - RomâniaMARIA GEORGESCU - RomâniaAL JASHI ISAM - RomâniaMANOLE COJOCARU - RomâniaJEAN PIERRE NAIM - ElvetiaCALIN PETRU TATARU - RomâniaBOGDAN SAVU - România

ATHANASIOS CHRISTOPOULOS - CipruCRISTIAN POPA - CipruANNA MODELSKA - PoloniaIOAN ANCUTA - RomâniaPANAGY GEORGIOU - GreciaELEONORA LUKA PILLA - Elvetia DIMITRI MIHAILOV - OlandaCRISTIAN NITESCU - RomâniaDRAGOÇ GEORGESCU - RomâniaDIMITRIE NANU - RomâniaECKAT HANEKE - Germânia

REDACTORLIVIA TRISCAS

CORECTURACIP BRAND FACTORY

DESIGNERCIP BRAND FACTORY

DIRECTOR DIFUZAREGABRIEL STOICHICI

Tiparita la

Articolele publicate în aceasta editie sunt copyright © THE ROMANIAN ANTI-AGING

MAGAZINE

I.S.S.N. 1842 - 5666

REDACTIA SI ADMINISTRATIADrumul Taberei 35, bl. 803, ap.4, Sector 6, BucureçtiTel: (021) 725.66.08; Fax: (021) 413.02.12E-mail: [email protected]; www.amaa.ro

Rezumate & abstracte Rezumate & abstracte

ProgramProgrampag. 6

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abonati

EMC

5credite

anul 3, nr.8, aprilie 2008

rd3 INTERNATIONAL CONGRESSOF ANTI-AGING MEDICINE

st1 INTERNATIONAL CONGRESS FOR LASERS IN MEDICINE AND SURGERY

2 - 4 MAI, BUCHAREST, ROMANIA National Institute of Statistics

MEDICINA ANTI - AGING(PREVENTIE, LONGEVITATE SI CALITATEA VIETII)

DERMATOLOGIE COSMETICA &LASERE IN MEDICINA SI CHIRURGIE

ndFriday 2 of May12.00 - 14.00 Registration

Anti - Aging Medicine

PROGRAM

Hour Title Speakers Location

14.30 - 14.45 Healthy aging between myth and reality

R Pircalabu, I Raducanu, R.Hnidei, B.Morosanu, R NacuINGG “Ana Aslan”

Human blood precursors differentiation from umbilical cord blood in beta-insular pancreatic cells.

1Catalina Monica Pena , Octavian-Gabriel 2 1Olaru , Crina Amalia Carazanu

1-« Ana Aslan » National Institute of Gerontology and Geriatrics, Bucharest, Romania 2- Bucur Mathernity, Sf. Ioan Hospital, Bucharest, Romania

14.45 - 15.00

Endogenous antioxidants andgenetic risk factors

Cristina Ionescu, Elena Lupeanu Institutul National de Gerontologie si Geriatrie Ana Aslan

15.00 - 15.15

Molecular mechanisms of ageingin the rat olfactory system

Daniela Gradinaru INGG “Ana Aslan”

15.30 - 15.45

Vitamin D: new indicationsand novel therapies

Dr. Jean-Pierre Naim M.D Geneva,Switzerland

15.45 - 16.15

Multidisciplinary Complex System for the Efficient Manage-ment of the Anti-Aging Information (AgingNice)

1 1Marilena Ianculescu , Monica Pârvan , 2 3Horia Păunescu ,Laurenţiu Coman ,

2Oana Andreia Coman 1 National Institute for R&D in Informatics 2 Dermatovenerology, Clinical Hospital of Dermatovenerology. 3 Department of Physiology, UMF “Carol Davila”.

16.15 - 16.30

MAIN

HALL

14.15 - 14.30 Double Sensorial Impairment,Cause of a Greater Stress for Elderly Persons

Doina Roditis INGG “Ana Aslan”

CHAIRMAN Dr. Robert Goldman, Dr. Cornelia Rusu, Dr. Jean-Pierre Naim

14.00 - 14.15 Opening ceremony Dr. Robert Goldman MD, PhD, DO, FAASP - Chairman of the Board A4M

Dr. Bogdan Dimitrie Niculae MD, BSc - President AMAA Dr. Catalin Enachescu, MD, BSc - General Secretary AMAA

Third Romanian InternationalCongress of Anti - Aging Medicine

First Romanian InternationalCongress of Lasers in Medicine

and Surgerynd thBucharest, 2 - 4 May 2008

National Institute of Statistics


MAIN

HALL

Microbiologic considerations in sepsis in elderly

1Alexandra Dana Maria Panait , 2 3

M. Cojocaru , M. Negut 1 National Medicine Agency 2 Colentina Clinical Hospital 3 Carol Davila University of Medicine and Pharmacy

16.30 - 16.45

Mitochondria and peroxisomes role in oxidative stress associated with aging

Elena LupeanuNational Institute of Gerontology and Geriatrics “Ana Aslan”

16.45 - 17.00

Mild stress as a modulatingfactor in aging

Mariana Rachita *,Gabriela Diaconeasa** *Institutul National de Gerontologie si Geriatrie “Ana Aslan” **Qeme proiect S.R.L.

17.00 - 17.15

Atypical symptoms of debut, element specific for thyroid disorders on elderly

Dr. Ileana Raducanu, dr. Raluca Pircalabu,Dr. Bogdan Morosan, dr. Rodica Hnidei, Dr. Catalina Pena INGG “Ana Aslan”

17.15 - 17.30

Restless legs syndrome – a motor disorder characteristics to the elderly patient

Dr. Ileana Raducanu, dr. Raluca Pircalabu,Dr. Bogdan Morosan, dr. Rodica Hnidei, Dr. Catalina Pena INGG “Ana Aslan”

17.30 - 17.45

Advanced oxidaton proteinproducts - marker of oxidative stress in aging

Claudia Borsa INGG “Ana Aslan”

17.45 - 18.00

Particularities of the coronary disease risk factors in the elderly

Bogdan Morosanu, Dora Morosanu, Raluca Pircalabu, Ileana Raducanu,Rodica Hnidei, Cristina Ionescu

18.00 - 18.15

Cellular immune status in old healty subjects selected according to the senieur protocol

Andrei VictoriaNational Institute of Gerontology and Geriatrics Ana Aslan

18.15 - 18.30

18.30 COCKTAIL NATIONAL INSTITUTE OF STATISTICS

CHAIRMAN Dr. Jean Pierre Naim, Dr. Gloria Sabater

ndFriday 2 of May

thSaturday 3 of May09.00 - 11.00 Registration

13.00 - 14.00 Lunch break

WORKSHOPS

Dr. Manfred Herold, Dr. Katharina Russe-Wilflingseder, Dr. Leonardo Longo, Dr Stefan Manea

The use of transilumination and doppler echography for localization of varicose and teleangiectatic veins

Dr. Tanase Mihai, Dr. Savu BogdanDr. Bogdan Dimitrie Niculae

The treatment of the venectatic problems with sclerotherapy and Dye laser .


Prof. Dr. Eckart Haneke Course on nail surgery 09.00 - 09.50

Endovenous laser- Theoretical and practical approach


10.50 - 11.20

Varioderm-a new generation of hyaluronic acid filler

Dr.M.Weidmann,MD,Dermatologist,Augsburg-Germany

10.00 - 10.50

Dr. Charbel Kamel Non surgical face rejuvenation,using a combination of multiple techniques.immediat result

11.20 - 12.20

WORKSHOP

HALL

12.20 - 13.00 Q&A for the workshops Prof. Dr. Eckart Haneke,Dr. M. Weidmann,Dr. Tanase Mihai,Dr. Charbel Kamel


Presbyastasis-the syndromeof instability in the elderly

Dr.G. Musat, Prof. Dr. D. Sarafoleanu Clinica O.R.L.”SF.MARIA”

09.30 - 09.55

Laser CO2 surgical treatment in oropharyngeal pathology

Dr. Iustina Andrian Senior ENT, Dr. Tanasescu Ioana Senior ENT C.M.D.T. of S.R.I.

10.25 - 10.40

Laser CO2 surgical treatment inhyperplastic inferior nasalturbinates

Dr. Tanasescu Ioana Senior ENT, Dr. Andrian Iustina Senior ENT C.M.D.T. of S.R.I.

10.40 - 10.55

Improving esthetic withimplant-supported mandibular overdenture

Cristache Gh. ORLCristache Corina-Marilena, DMD, PhD, Concordia DentIonescu Camelia, UMF Carol Davila, Diaconu Daniela

10.55 - 11.10

10 Year Follow Up of Laser HairRemoval with Alexandrite Lasers

Dr. Katharina Russe-Wilflingseder

Laser, Fillers,Toxins what to do? Dr. Katharina Russe-Wilflingseder

Facial Rejuvenation with Ablative and Non Ablative Fractional Photothermolysis

Dr. Katharina Russe-Wilflingseder 11.40 - 12.35

Rheumatology and“chrondroitin”

Prof. Manfred Herold

Knuckle Pads - sucsessful treatment with ablative laser

Prof. Manfred Herold 12.35 - 13.00

MAIN

HALL

09.55 - 10.25 Natural products having protector effect against the oxidative stress involved in aging processes

HOFIGAL

11.10 - 11.40 Mechanisms of light and laser inthe skin rejuvenation

Prof Dr. Leonardo Longo

09.00 - 09.30 SYMPOSIUM AVENE

CHAIRMAN


PROGRAM LECTURES

thSaturday 3 of May

20.30 GALA DINNER Mariott Grand HotelRecital A.G. Weinberger

Cvartetul ARPEGIONEMIKI

PROGRAM LECTURES

Efficacy in rejuvenation and resurfacing of the skin by the fraxel tehnique of intens pulse light

C.Solovan, Maria Ciolan, Maria IordacheDerma Light Center, Timisoara

14.20 - 14.35

Filler update with special emphasis on risks and benefits of permanent fillers"

Prof. Dr. Eckart Haneke 14.35 - 15.00

Treatment of Acne Scars and Skin Rejuvenation with 1440 nmAnti-Aging Wavelenght with Combined ApexPulse (CAP) Technology.

Dr. Andreas Roumbas15.00 - 15.20

Lasers applications in medicine, surgery and biology: The Romanian Chapter.

Prof. Mihail Lucian Pascu15.20 - 15.50

"Cosmetic Effect of Low Power Diode Laser (670 nm) Light on the Healing of Burns"

Dr. Farouk Al-Watban 16.20 - 16.50

Optical/laser methods to fight resistance to treatment

M. L. Pascu, Angela Staicu, Ruxandra Pascu, Madalina Dicu, B. Carstocea

15.50 - 16.20

Comparasion of Efficiency of DyeLaser therapy in angiomas with other methods

Alin Nicolescu- C.M.D.T. RomaIrinel Nedelcu- Spitalul Colentina

16.50 - 17.05

The place of CO2 Laser in Melanocityc nevus

Irinel Nedelcu- Spitalul Colentina Alin Nicolescu- C.M.D.T. Roma

17.35 - 17.50

MAIN

HALL

14.00 - 14.20 Facial rejuvenation with new concepts.

Dr. M. Weidmann, MD,Dermatologist, Augsburg-Germany


The Role of Dye Laser inDermatology – 11 years experience

17.05 - 17.20

WORKSHOPS

BOTOX Training Workshop for Facial Aesthetics and hyperhidrosis

Dr. F.S. Butt15.00 - 17.00

Laser Therapy & Laser SurgeryHANDS - ON

Dr. Bogdan SavuDr. Bogdan Dimitrie Niculae

17.00 - 18.30

Easy TCA – TCA superficial peel – Skin Tech aesthetics aplication

Dr. Daniela Taher14.00 - 15.00

17.20 - 17.35 Cutaneous Ecography – New Method of Diagnose in Development


Angioma Treatment with Dye Laser Alin Nicolescu- C.M.D.T. RomaIrinel Nedelcu- Spitalul Colentina

17.50 - 18.05

CHAIRMAN Prof Dr Eckart Haneke, Dr. Farouk Al-Watban, Prof. Mihail Lucian Pascu, Dr. Andreas Roumbas

WORKSHOP HALL



thSaturday 3 of May SIMPOSIUM

Stabilized NASHA Hyaluronic Acid – in Restylane products –Q-MedSuperlative in IPL treatments- Pulsar technology

ITALTRADE10.00 - 10.30

*SEE. TRY. BUY Company SRL

BTLSMOOTH AND BEAUTIFUL SKIN.........THE DREAM OF EVERY WOMEN

11.30 - 12.00

14.00 - 14.30 Cord blood banking: a complementary approach in regenerative medecine

Dr. Eric L. MEHUYS, MD, MSc, MBAInternational Medical Affairs ManagerCryo-Save GROUP

10.30 - 10.45 Q & A PANNEL

11.15 - 11.30 Q & A PANNEL

12.00 - 12.15 Q & A PANNEL

14.30 - 14.45 Q & A PANNEL

New Anti-Aiging concepts /Mesotherapy including MPS-system

Dr. M.Weidmann, MD,Dermatologist, Augsburg-Germany

14.45 - 15.15

15.15 - 15.30 Q & A PANNEL

Dr. Radu TudosePractical aplications of IPL technologyin aesthetic medicine

15.30 - 16.00

16.00 - 16.15 Q & A PANNEL

ELLMANSYMPOSIUM RADIAGE16.15 - 16.45

16.45 - 17.00 Q & A PANNEL

SYMPOSIUM

HALL

LUNCH BREAK

Use of the diode Lasers in Endo Veintreatment and the new possibilities of Laser using in the Liposuction,

17.00 - 17.30 Angelika Zigan (Biolitec – Germania) Miklós Antal (Biolitec – Ungaria)

17.30 - 17.45 Q & A PANNEL

JULIETTE ARMANDPhytopeel - The most safe chemicalpeel

12.15 - 12.45

12.45 - 13.00 Q & A PANNEL

Superlativul in tratamentele cu IPL- Tehnologia Pulsar" *

10.45 - 11.15 Dr. Hugues Cartier

Teosyal - the best of hyaluronic acid* Dr. Stefan Negu Sadoveanu

SYMPOSIUM

HALL



Stress, inflamation and relatedpatologies

DR Gloria Sabater

Fibrotic and inflammatory changes in normal aging processin liver structure

Crina Amalia Carazanu INGG Ana Aslan

10.30 - 11.15

Eficient herbal solutions in insulineresistence

DR.Luka Pilla11.15 - 11.30

11.30 - 11.45

11.45 - 12.00

thSunday 4 of May

MAIN

HALL

12.00 - 12.15

12.30 - 12.45

Quantic physics approaches inhomeopathy

DR.Luka Pilla

09.30 - 09.45

Quality of sexual life in menopause

Al-Jashi Isam, Prof. Dr. D. Nanu,Dr.A.MateiCARITAS HOSPITHAL

09.45 - 10.30

LECTURES* & WORKSHOPS**

CHAIRMAN DR.Luka Pilla, DR Gloria Sabater, Dr. Charbel Kamel

PROGRAM LECTURES

Oxidative stress assesment and interpretation

DR Gloria Sabater

12.15 - 12.30

May green tea prevent atherosclerosis?*

* Ciomaga Georgeta –SPITALUL “C.I. PARHON “ IASI Nanescu Sonia Elena –U.M.F. IASIAgheorghiesei Madalina-SPITALUL “C.I. PARHON “ IASI

The involvement of green tea incardiovascular diseases.

The incidence of cardiovascular diseases at third age females with associated climax metabolic syndrome.*

Nanescu Sonia Elena –U.M.F. IASI Ciomaga Georgeta –SPITALUL “C.I. PARHON “ IASI Agheorghiesei Madalina-SPITALUL “C.I. PARHON “ IASI

Endovenous Laser - Personalexperience.*

DR Tanase Mihai

Irinel Nedelcu- Spitalul ColentinaAlin Nicolescu- C.M.D.T. Roma

Alternative Treatment in alopeciaareata.*Hair Implant, Actualities.* Irinel Nedelcu- Spitalul Colentina

Alin Nicolescu- C.M.D.T. Roma

Dermal Fillers Training Workshop for Facial Aesthetics**

Dr. F.S. Butt10.00 - 12.00

Age related changes in skin aging. Morpho-physiological differences related to gender. *

Dr Anca Laura SPITALUL DE DERMATO-VENEROLOGIE TIMISOARA

SYMPOSIUMHALL

09.30 - 09.45

09.45 - 10.00

12.00 - 12.15

12.15 - 12.30

Dermatologic procedures inAnti-Aging Medicine.*

Dr. Bogdan Dimitrie NiculaeDr. Cristian NiţescuLasermed Medical Centers

12.30 - 13.00

CHAIRMAN Dr. F.S. Butt, Dr. Tanase Mihai, Dr. Bogdan Dimitrie Niculae

The patient work - up for cataractsurgery*

DR Adina Enachescu13.00 - 13.15

12.45 - 13.00 Anti-aging cosmetic products based on natural plant-origin antioxidants

St. Manea, V. Carabela, V. Tamas, G. Alexandru, D. Ionescu

12.45 - 13.00 Antioxidanti naturali in tratamente “anti-aging”

Nora Rădulescu, Elena Mazilu, Maria Mitru, Gabriel Ivopol



14

Dr. Robert Goldman, MD, PhD, DO, FAASP

Dr. Robert M. Goldman MD, PhD, DO, FAASP has spearheaded the development of numerous international medical organizations and corporations. Dr. Goldman has served as a Senior Fellow at the Lincoln Filene Center, Tufts University; as an Affiliate at the Philosophy of Education Research Center, Graduate School of Education, Harvard University; and also as Professor, Graduate School of Medicine, Swinburne University, Australia, He is Clinical Consultant, Department of Obstetrics and Gynecology, Korea Medical University. He is Professor, Department of Internal Medicine at the University of Central America Health Sciences, Department of Internal Medicine. Dr. Goldman holds the position of Visiting Professor, Udayana University School of Medicine, Indonesia. He also serves as Visiting Professor, Huazhong University of Science & Technology Tong Ji Medical School, rated among the top three medical universities in China; and Visiting Professor, The Wuhan Institute of Science & Technology, the top biotechnology private university in China. Dr. Goldman is a Fellow of the American Academy of Sports Physicians and a Board Diplomat in Sports Medicine and Board Certified in Anti-Aging Medicine.

Dr. Goldman received his Bachelor of Science Degree (B.S.) from Brooklyn College in New York, then conducted three years of independent research in steroid biochemistry and attended the State University of New York. He received the Doctor of Medicine (M.D.) Degree from the Central America Health Sciences University, School of Medicine in Belize, a government-sanctioned, Ministry of Health-approved, and World Health Organization-listed medical university. He received his Doctor of Osteopathic Medicine and Surgery (D.O.) degree from Chicago College of Osteopathic Medicine at MidWestern University. His Ph.D. work was in the field of androgenic anabolic steroid biochemistry.He co-founded and served as Chairman of the Board of Life Science Holdings, a biomedical research company which has had over 150 medical patents under development in the areas of brain resuscitation, trauma and emergency medicine, organ transplant and blood preservation technologies. He has overseen cooperative research agreement development programs in conjunction with such prominent institutions as the American National Red Cross, the US National Aeronautics and Space Administration (NASA), the Department of Defense, and the FDA's Center for Devices & Radiological Health.Dr. Goldman is the recipient of the 'Gold Medal for Science, the Grand Prize for Medicine, the Humanitarian Award, and the Business Development Award.Dr. Goldman received honors from Minister of Sports and government Health officials of numerous nations. In 2001, Excellency Juan Antonio Samaranch awarded Dr. Goldman the International Olympic Committee Tribute Diploma for contributions to the development of sport & Olympism.

In addition, Dr. Goldman is a black belt in karate, Chinese weapons expert, and world champion athlete with over 20 world strength records, he has been listed in the Guinness Book of World Records. Some of his past performance records include 13,500 consecutive situps and 321 consecutive handstand pushups.Dr. Goldman was an All-College athlete in four sports, a three time winner of the John F. Kennedy (JFK) Physical Fitness Award, was voted Athlete of the Year, was the recipient of the Champions Award, and was inducted into the World Hall of Fame of Physical Fitness. Dr. Goldman was awarded the Healthy American Fitness Leader Award from the President's Council on Physical Fitness & Sports and U.S. Chamber of Commerce.Dr. Goldman is Chairman of the International Medical Commission overseeing sports medicine committees in over 176 nations. He has served as a Special Advisor to the President's Council on Physical Fitness & Sports. He is founder and international President Emeritis of the National Academy of Sports Medicine and the cofounder and Chairman of the American Academy of Anti-Aging Medicine (A4M). Dr. Goldman visits an average of 20 countries annually to promote brain research and sports medicine programs.Dr. Goldman with friend Governor Arnold SchwarzeneggerDr. Goldman with friend Governor Arnold Schwarzenegger. Dr Goldman served as Special Advisor to the President's Council on Physical Fitness & Sports under Gov Schwarzenegger's Chairmanship of the Council.

THE IFBB GOLD ORDERDr. Robert Goldman (USA) , World Chairman IFBB Medical Commission, receives the IFBB's highest award - the IFBB Gold Order, at the World Championships in Shanghai, China, 2005 Shown here with Dr Rafael Santonja (Spain) past President of the Olympic Weight Lifting Federation of Spain, and Prof. Dr. Eduardo H. De Rose (Brazil), of the International Olympic Medical Commission.

Dr Goldman receiving the Key to the City from the Mayor of Catania, Italy (Dr Umberto Scapagnini) in Sicily with EU government officials looking on.

SPECIAL GUESTSSPECIAL GUESTS

15

Prof. Dr. med. Eckart Haneke

Study of medicine at the Medical Faculty, Martin-Luther-University Halle-Wittenberg in Halle/Saale 1960-1966Internship in Internal Medicine, Surgery, and Physiological chemistry 1966-1967Dermatology training at Dept Dermatol, Martin-Luther-University Halle 1967-1971, board certification 1971Dept Dermatol Univ Erlangen 1975-1986Professor and chairman, Dept Dermatol Wuppertal Hosp, Acad Teaching Hosp Universities Düsseldorf and Witten-Herdecke 1986-2000Head, Inst Dermatol, Klinikk Bunaes, Sandvika, Oslo, Norway 2000-2004Honorary Consultant, Dept Dermatol, Univ Med Ctr St Radboud, Nijmegen, Netherlands, 2004-2005Present position: Dermatologist, Dermatol Clin Kaiser-Joseph-Strasse, Freiburg, Germany, Lecturer Dept Dermatol Inselspital Bern, Switzerland & Honorary Consultant, Dept Dermatol, Univ Med Ctr Gent, Belgium

MD: Univ Halle 1968. PhD: Univ Erlangen 1978. Associate professor: Erlangen 1979. Clinical professor: Erlangen 1980

Special interestsDermatopathology, dermatological surgery, nail diseases, diseases of the oral mucosa, aesthetic dermatology

Publications>200 journal articles, >120 book chapters, author of 1 book, co-editor of 5 books, >1000 lectures at national and international meetingsReviewer for Arch Dermatol, Br J Dermatol, Eur J Dermatol, Hautarzt, J Am Acad Dermatol, J Eur Acad Deramtol Venereol, J German Soc Dermatol etc.Member of the editorial board of several journals

SocietiesGerman Dermatol Soc, German Soc Dermatol Surg Oncol, Aust Soc Dermatol (Corresponding member), Asoc Colomb Dermatol (Honorary member), German Mycol Soc, Mex Soc Dermatol Surg (Hon memb), Turk Dermatol Soc (Hon Memb), Pol Soc Dermatol (Hon Memb), Norweg Soc Dermatol, Int Soc Dermatol Surg (Past president), Eur Nail Soc (President), Eur Soc Cosm Aesthet Dermatol (Past pres), Eur Acad Dermatol Venereol, Dermatological Surgery Group Swiss Soc Dermato Venereol (Hon Member)

Katharina Russe-Wilflingseder M.D. . Katharina Russe-Wilflingseder graduated at Innsbruck University and recieved her medical degree from Innsbruck University. She completed her residency in general and plasic surgery at the University of Innsbruck. She is a board certified Plastic Surgeon and a board certified General Surgeon. Katharina Russe-Wilflingseder is in private plastic surgery practice specializing in aesthetic surgery, laser surgery and cosmetology. She is operating her own office clinic and laser center. She holds appointments for Plastic Surgery at Sanatorium Kettenbrücke in Innsbruck and at F. X. Mayr Zentrum in Igls, Austria. She is International Consultant of the Servicio de Fotomedicina, Plataforma Láser of Centro Médico Teknon in Barcelona, Spain and Professor at the University Politècnica de Catalunya, in Barcelona, Spain Katharina Russe-Wilflingseder has published and lectured on a national and international basis on laser and plastic surgery.

Manfred Herold, MD PhD (chemistry)

Education1955 - 1959 elementary school in Innsbruck 1959 - 1967 high school in Innsbruck 1967 - 1975 study in chemistry at University of Innsbruck with thesis at theInstitute of Physical Chemistry

title of thesis: Investigations on oxidation and adsorption of methanol onpolycrystalline platinum

5. Juli 1975 graduation to Dr. phil. (PhD in chemistry) at University of Innsbruck 1976 - 1981 study in medicine at University of Innsbruck 7. Feb 1981 graduation to Dr. med. univ. (MD) at University of Innsbruck March 1979 stay at Chronobiology Laboratories, University of Minnesota,

Minneapolis, USA March 1987 diploma in Internal Medicine Feb 1992 diploma in laboratory medicine Nov 1993 “Habilitation” (assistant professor) in internal medicine Feb 1999 diploma in internal medicine - rheumatology

Positions 1972 - 1975 scientific assistant at the Institute of Physical Chemistry 1975 - 1976 university assistent at the Institute of Physical Chemistry 1976 - 1981 university assistent the Dept. of Physical Medicine and Rheumatology at the

university hospital of internal medicinesince 1981 university assistent at the university hospital of internal medicine in Innsbrucksince 1989 head of laboratory at the university hospital of internal medicine in Innsbrucksince 1994 academic head of school for laboratory technicianssince 1999 head of rheumatology unit at the hospital of internal medicine in InnsbruckT

Teaching 1979 - 1998 lectures in general and anorganic chemistry, clinical chemistry and laboratory instrumentation at school for technicians in Innsbruck

since 1981 bed side teaching for medical students at university hospitalPublications 2 books

230 papers (25 as first author) 29 book contributions (15 as first author) 21 letters to the editor228 abstracts (50 as first author)

16

DR.Charbel Kamel

TITULOS:-licenciado en medicina y cirugía .universidad autónoma de Barcelona.1979.-medico especialista en cirugía general del hospital Valle Hebron. Universidad Autónoma de Barcelona. 1981.IDIOMAS: Castellano, ingles, francés, árabe.DIPLOMAS:-Cirugía y medicina estética en el servicio del DR. JAVIER HERRERO CLINICA TEKNON.2003/2004.-Miembro de la sociedad española de medicina antienvejecimiento: (SEMAL) 2006. -Inamed aesthetics: técnicas de rejuvenecimiento facial: 2004.-Curso de cirugía de urgencias ciudad sanitaria Valle Hebron. Barcelona.-Primer simposium internacional sobre tumores endocrinos: apudomas. Hospital valle hebrin1978.-Curso sobre cirugía hepática y vías biliares. Hospital san Rafael. Barcelona. --curso en cirugía laparoscopia centre Hospitalier Cochin-PARIS-FRANCE.

-curso de cirugía laparoscopia experimental en laboratorio. hemlin sobre animales. LIBANO. CONGRESOS y WORKSHOP:(Participar en la organización) Técnicas innovadoras en medicina y cirugía estética (Hilton hotel. Barcelona 2007) talleres en directo.-Congreso sobre miastenia gravis .Barcelona 1980. -Congreso sobre tumores pancreáticos: apudomas. Barcelona.1982.CONFERENCIANTE-PONENTE-Sobre Lipólisis en el curso de la sociedad Española de cirugía y medicina cosmética (SEMCC)) Montbrió. Noviembre 2007-Sobre rejuvenecimiento facial. en el congreso de la sociedad SUIZA de anti-envejecimiento (SAAAM) utilizando técnicas propias combinadas de hilos tensores. rellenos y Botox. Diciembre 2007-En miastenia gravis 1980 Barcelona.1980.DR. J.M.PONSETI & al-En miastenia gravis. LYON-FRANCIA.1981.DR. J.M.PONSETI & al-En apudomas. Barcelona 1982-En cáncer de tiroides, con participación del colegio de médicos de NEW JERSEY. Barcelona.1982-Participar en estudio multi-céntrico. sobre tratamiento combinado de la esofagitis. BRUSELAS-BELGICA.1982-Participar en estudio multi-céntrico sobre la célula grasa (adiposito) junto a LYON-GINEBRA PARIS-BARCELONA.PUBLICACIONES-Cirugía Española: apudomas pancreáticos. DR. GOMEZ PEREZ & al.-Película científico-médicas sobre miastenia gravis DR. J.M.PONSETI & al.EXPERIENCIA PROFESIONAL-Medico adjunto contratado interino. Valle Hebron 1983-Cirujano de guerra. (Líbano 1984-1996)-Presidente del comité medico del hospital Pasteur Líbano 1995-2000-Cirugía y medicina estética en centro medico TEKNON –Barcelona en el servicio del DR. JAVIER HERRERO.2003.-Jefe de equipote cirugía en la CLINICA CIMA. Barcelona desde 2006-Cirujano del HOSPITAL DE BARCEONA-asistencia sanitaria.-Medico adjunto de urgencias (cirugía) mau en el hospital de la cruz roja-Hospitalet (2004)en hospital Germans Trias i Pujol-Can Ruti. Badalona (2005/06/07)en el hospital de Granollers.(2005/06/07).

Prof. Dr. Leonardo Longo• Degree in Medicine and Surgery obtained from the University of Florence, academic year 1979/1980, grade 110/110 with honors; thesis: " Experimental study on the histopathological effects of laser radiation " (Thesis adviser Prof. GC. Zampi,- Director, Institute of Pathological Anatomy).• Obtained specialization in Endocrinology, academic year 1983/1984 , thesis:" Preliminary considerations on the use of lasers in hormone level regulation" (Adviser: Prof. G. Giusti; grade 70/70).• Collaborated with CNR (National Research Council) in the " Laser Project: subproject: Medical Applications ", in the CLAM 2 unit (Director: Prof. A.G. Sesti, MD, PhD), from 1977/1982• Attended the Laser Center connected to the "Centro Bronco-Asmatici" of the "G:Casoni" Institute at Poggiosecco (Florence); rendered official by the INRCA resolution dated 18/2/1982 , til 1986.• Director of the Laser Department of the 'Villa Donatello" Hospital in Florence, from 1985 til 1991 .• Instructor, Mid-Laser Treatment Practical Course I (Coordinator: Prof. B. Palmieri), University of Modena, June 17-19, 1983 .• Director of 21 Laser Treatment Courses at the "International University of Bologna" (Chairman: Prof. L. Cattaneo)

from September 1982 to September 1989.• Consultant of Istituto per i Rapporti Internazionali di Sanità (IRIS), from 1987 til 1992 .• Collaboration with WHO and EC in the European Program concerned with the study of laser applications in Medicine and Surgery (1988-1990).• Chief of Department of Laser Surgery and Medicine, European School for Medical Practice, Florence, from 1992 til 1996.• President International Course on Laser Phlebology, during the 1° International Simposium and 1° National Unified Meeting of Italian Society of Phlebolymphology and Italian Society of Phlebology, Siena , 23-25 September 1996.• Director of Laser Medicine and Surgery Service of "Istituto Prosperius - Sezione Ricerca Medica" and Private Hospital "Villa Cherubini" in Florence, from 1991 till present.• Chief of Institute for Laser Medicine of Florence (I.L.M.), from 1995 - present.• Teacher of Plastic Laser Surgery and Medicine and Laser General Surgery on Specialization School in General Surgery of Siena University, General Surgery Institute and Surgical Specialization (Director, Prof. Sergio Mancini, M.D., PhD), from 1995/96-present.• Teacher of Laser Phlebology on Post-Graduate Course on Phlebology of Siena University, from 1996-97 til present• Teacher of Laser Treatment of La Peyronie's Disease on Specialization Residency in Andrology of Pisa University, from year 1996/97 .• Consultant of Phlebology Laser Center of Siena University, from 1996 til present• External Consultant on Laser Technology of Plastic Surgery Residency - Florence University (Director Prof. D. Lo Russo, M.D., Ph.D.), from 1994-till 96.• President Laser Florence International (annual) Congress and Courses from 1997 until today• Co-Director of the Courses Laser Phlebology, Laser cosmetic Surgery, Laser Resurfacing, approved by the American academy of dermatology, from 1998 until today• Teacher of Laser Therapy and Surgery of Scuola di Specializzazione in Medicina Estetica – Fondazione Fatebenefratelli – Roma, from 1998 today

• Director and Teacher Course on Laser Aest. Medicine, Ortona, 15° Corso di Base in Medicina Estetica, 26-29 /5/ 2000-• Director and Teacher Course on Laser Aest. Medicine, Poland Society of Aesthetic Medicine, Warzaw, since 2000 until today

• Director and Teacher Course on Laser Aest. Medicine, World Association for Laser Medicine and Surgery2Tokyo,28-30/6/ 2002• Teacher Course on Laser Dermatology Surgery, International Society for Laser Med. and Surgery, Chennai University, India, 27-30 August

2001• Comentador Workshop on Laser y Luz Pulsada - Forum venoso latino-Americano, 18-20 October

2001, Buenos Aires, Argentina

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• Visiting Research Professor Uniformed State Universities Health Services – USUHS,Bethesda, USA, from 2003• Teacher Corso di Flebologia, 14 June, 2003, Istituto Prosperius di Firenze, Italian Health Office, ECM Program• Teacher Corso di Flebologia, 25 Ottobre 2003, Casa di Cura Val di Sieve, Firenze, , Italian Health Office, ECM Program• Chair, Modulo di Laser Terapia e Chirurgia, Master in Medicina e Chirurgia Estetica, Universita' di S. Marino, Year 2003-2004MEMBERSHIPS• Member of the International Society for Laser in Surgery and Medicine, from 1982 .• Member of the European Laser Association (ELA), from 1982 .• Founding Member of the European Medical Laser Association (EMLA), from 1984.• Fellow of the American Society for Laser Surgery and Medicine from 1996.• President Italian Section of EMLA, from 1987 till 1996.• President of EMLA, from 1996 till 2000 .• Member of the Società Italiana di Laser Chirurgia e Medicina (SILCM), from 1982 .• Honorary Member of the Société Suisse de Laser Thérapie, from 1988 .• Member of the Società Italiana di Magneto-Medicina. (SIMM), from 1983• Member of the Società Italiana di Gerontologia e Geriatria (SIGG), from 1981• Member of the Associazione Italiana per lo Studio del Dolore (AISD), from 1984• Member of the Società Italiana di Flebo-linfologia (SIFL), from 1987• Founding Member of the European Federation of Medical Laser Centers (EFMELC), from 1992• Member of Collegio Italiano di Flebologia, from 1996• Honor Member of Eastern European Confederation of Societies for Aesthetic Surgery and Aesthetic Medicine (ESPAS)• Founding member of SITIF – Italian Society of Integrated Therapy in Phlebology, from 1997• Honor Member of the Asociation Rosarina de Laser Terapia y Cirurgia, Rosario, 2000- Honor Member of Radiobiology Soc. of the Czech Medical Society of J.E. Purkynje , from Year 1999• Member of American National Standard Institute, from 2000.• Founding Member and President of International Academy for Laser Medicine and Surgery – IALMS, Florence, 2000• Member of New York Academy of Science, from 2001• Member of Board of the Director, International YAG Laser Society, from 2002• President Elected, Year 2005-2007, International Society Laser Medicine and Surgery – ISLMSMEETING TITLES• Chairman , I° Congr. Internaz. di Laser Terapia Medica, Modena,17-19 Giugno 1983• Chairman del Simposio su Elasto-compressione in Flebolinfologia Soc. Ital. di Flebolinfologia,Punta Ala (GR),11 Novembre 1989• Co-chairman Forum Laser in Medicina Ordine dei Medici di Firenze,17 Luglio 1990- Chairman Sessione Lasers in flebolinfologia I° Congr. Naz. Soc. Ital. di Flebolinfologia,Cortona,13-14 Sett. 1990• Chairman Session General Surgery III - Colorectal Surgery 5th Internat. Congr. of the European Laser Association (ELA), Graz, A, November 8-10,1990• Chairman Sessione Laser a Bassa Potenza 9° Congr. Naz. Soc. Ital. di Laser Chir. e Med.,Roma,21-23 Nov. 1991Organizing Secretary 11° Congr. Naz. Soc. Ital. di Laser Chir. e Med. Firenze,21-23 Ottobre 1993• President 5 th EMLA International Congress, Firenze, 18/20 Settembre 1997.- Co-Chairmen and Chairman of two scientific session, President of one session and Invited Speaker on 2 th International Congress of World Association for Laser Therapy (WALT), Kansas City, 2-6 th September, 1998• Chairman on the session Laser in Phlebology, 3 r d Congress of Italian College of Phlebology, Perugia , September 30 th , 1998- Chairman session and Invited speaker , International Symposium on Cutaneous Ulcers, Milan, 18-20 June, 1999• President, Laser Florence 98, 99, 2000, 2001, 2002 International Expo-Meetings and Courses, Florence, Italy• Co-Director, Courses on Laser Phlebology, Laser Resurfacing, Laser Cosmetic Surgery, in Laser Florence 98, Laser Florence 99 and 2000• Honor President and Chair of Session 6 th EMLA Congress, Bucharest,Romania, 3-6 June, 1998• Honor President and Chair of Session 7th EMLA Congress, Dubrovnik, Croatia, June 23-26, 2000• Invited Speaker, Maiman's Laser Party, 40 th Anniversary of Laser Born, Vancouver (Canada), 13-18 May, 2000• Chairman Session and Invited Speaker Romopto 2000 - SPIE International Congress, Bucharest, 3-7 September, 2000• Chairman Session and Invited Speaker on 3 rd and 4 th International Congress of Poland Soc. Of Aesthetic Medicine, Warsaw, 7-8 October, 2000; 3-5 October 2002 (Chair also of a Course on Laser Aesthetic Medicine), September 2004• Chairman Session and Invited Speaker on 13 th International Congress of Aesthetic Medicine, Union Internationale de Medicine Esthetique, November 1-4, 2000 - Monte Carlo (Principauté de Monaco)• Chairman session and Invited speaker Laser in Flebologia, XXII Congresso Naz. Societa' Italiana di Medicina Estetica, Roma, Aprile 2001,2002,2003,2004• Chairman session and Invited speaker , 14 th World Congress of the International Society for Laser Medicine and Surgery, Chennai, India, 27 th -30 th August 2001• Chairman session and Invited speaker In Phlebology II, Forum Venoso Latino-Americano, October 18 th – 20 th , 2001, Buenos Aires, Argentina• Honor President, Forum Venoso Latino-Americano, October 18 th – 20 th , 2001, Buenos Aires, Argentina• Chairman and Invited Speaker 4 th World Association for Laser Therapy, June 27-30 2002, Tokyo, Japan• Chairman and Invited Speaker on Day Surgery and Laser medicine, Catania University, 18-21 Aprile, 2002, ECM Course• Chairman and Invited speaker on International Congress of Asian-Pacific Society of Laser medicine and Surgery, Pattaya, Thailand, 16-22 October 2002• President and Chairman Sessioni Laser Congressi Annuali Societa' Italiana di Medicina Estetica, Roma, Marzo-Aprile, from 99 until today• Chairman Low Level Laser Therapy session, International Congress Laser Munich 2003, ISLMS, Munich, 26-28 June 2003• Chair Conference on Laser in Human Health, Acireale, 11.5.03, Istituto S. Michele• Chair Laser Sessions Italian College of Phlebology, Congress of Udine, 13-16 October, 2003• Teacher and Chairman laser session School of specialization in Aesthetic Medicine, Warsaw, September 2000, 2002, 2004• Teacher and Chairman Laser Therapy session, Master of second Level in Aesthetic Medicine and Surgery, Universita' degli studi Biomedici di S. Marino, Repubblica di S. Marino, from 2003• Leading invited Speaker, Czech Republic Soc. Laser Med. And Surgery and Purkinje Soc, Prague, September 2004• Leading invited Speaker , South Bohemia Unibersity of Czeske Budejovice, Czech Rep, September 2004

Dr. med. Michael Weidmannsenior house officer of Dermatology · Allergologie · Phlebologie, since 2003 in partnership with Dr. Oliver Dörzapf MD, Dr.K.P. Müller MD and Dr. Von Saldern MD in Augsburg/Germany and medical director of the clinic at Forsterpark.After studies in the universities of Ulm and Tübingen with clinical examination 1989 residencies in surgery, internal medicine and dermatology in Kiel/Germany.DSince 1997 in the department of dermatology at the university of Ulm and chair of the section of aesthetic dermatology and laser surgery until 2002.Specialised in laser treatments, filler, botulinum toxin and mesotherapy.Vice-president of the European Laser Aesthetic Surgery Society (ELAS)Chairman of the German Society of Aesthetic dermatologyMember of the German Society of Dermatology

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Dr. Eric L. Mehuys, MD, MSc, MBAInternational Medical Affairs ManagerCryo-Save GROUP

Eric L. MEHUYS is a medical doctor with a master course in molecular biology and biotechnology. Before joining the Cryo-Save Group (2006) he was active in the pharmaceutical industry.Special interest nowadays as the international medical director of the Cryo-Save GROUP is cord blood banking and all the issues concerning stem cells.

Cs SIlviu Solovan

professor universitar la disciplina de Dermatologie a UMF Timisoara, medic primar in specialitatea dermato-venerologie, s-a nascut la data de 01 ianuarie 1958 in orasul Timisoara, judetul Timis.A urmat cursurile preuniversitare la Scoala generala nr.3, intre anii 1964-1972, si liceul 'Nikolaus Lenau', absolvind la liceul nr.1 actualul Colegiu Banatean din Timisoara intre anii 1972-1976.Stagiul militar cu termen redus a fost satisfacut in perioada 1976/77.Din anul 1977 a urmat cursurile Facultatii de Medicina din Timisoara pina in anul 1983, cind a absolvit cu media generala 9,94.Examenul de Diploma a fost apreciat cu nota 10 pentru lucrarea de diploma cu titlul 'Valoarea clinica a scintigrafiei de miocard cu derivati fosforici marcati cu Tc99m in diagnosticul infarctului miocardic acut,prioritate nationala la acel moment.Dupa 3 ani de stagiatura ( 1983-86 ) efectuati in cadrul Clinicii Universitare de Dermato-Venerologie, Timisoara, urmeaza repartitia ca medic de medicina generala la Spitalul comunal Turceni, apoi ocupa prin concurs postul de medic de medicina generala in orasul Timisoara pina in anul 1990.In urma concursului de rezidentiat din toamna anului 1990( in primii 50 la acel moment) intra in specialitatea de dermato-venerologie, pe care o absolva prin sutinerea examenului de medic specialist din decembrie 1993, cu media 9,87 si confirmat prin ordinul Ministerului Sanatatii in februarie 1994. In iunie 1998 a sustinut si examenul de medic primar in specialitatea dermato-venerologie, confirmat prin ordinul Ministerului Sanatatii din martie 1999.Din 1991 a ocupat prin concurs postul de asistent universtar la disciplina de Dermatologie a Universitatii de Medicina si Farmacie Timisoara, cu integrare in Clinica Universitara Dermato-Venerologica.In toata aceasta perioada am participat la elaborarea unui numar de 90 de lucrari stintifice, din care 6 din tematica de doctorat, comunicate la diferite manifestari stiintifice si publicate in volume de rezumate si reviste de specialitate.Este membru in Comitetul National al Societatii Romane de Dermatologie, al Asociatiei Dermatologilor Romani de Sud-Vest, Societatii Romane de Imunologie, din anul 1995 este membru al Societatii Internationale de Citokine, si din 1999 membru al European Society for Dermatological Research.Din anul 2001 este membru in Academia Americana de Dermatologie, Academia Europeana de Dermatologie si VenerologieIn urma sustinerii tezei de doctorat 'Modificari unghiale in dermatozele buloase' sub conducerea prof.univ.dr.Virgil Feier, I se atribuie titlul de Doctor in Medicina in anul 1997; tehnica de determinare a oligoelementele din unghia umana prin tehnica microsondei electronice a fost prioritate nationala si nu numai. A publicat 3 cursuri pentru studentii stomatologi si 3 monografii de specialitate.Constant este membru a numeroase Comisii de examene si concurs de confirmare a medicilor specialisti si primary, cadre didactice si in comisii de doctorate.Numeroase monografii si articole stiintifice publicate.Membru al Academiei Europene de Dermatologie si Venerologie, Academia Americana de Dermatologie, Comitetul National al Societatii Romane de Dermatologie si VenerologieMembru in colectivul stiintific al Revistei Societatii Romane de Dermatologie si Venerologie, in colectivul de redactie a Scientifc International Journal, sectiunea medicinaCitat in Who's Who Romania, Medical 2006, si Who's Who in Medine and Healthcare sixth edition 2006-2007, edited by Marquis Who's WhoPremiu pentru Poster"Photo- Oxidative Stress in Patients with Porphyria Cutanea Tarda", Smaranda R.Gotia, C.Solovan, V.Feier, Persa Ghitulescu, Laura S.Gotia, Ioana Frentiu (publicat in volumul de rezumate al 3rd Spring Symposium, Sofia,2005, mai, pg.74), cistigat la Meeting-ul de Primavara EADV, Sofia,mai, 2005,recompensat cu suportarea cheltuielilor de participare la Meetingul feb-martie 2006 al Academiei Americane de Dermatologie.

aiu

Dr. Gloria Sabater, Ph.D. Dra. Gloria Sabater is the scientific advisor of Sabater Analysis. She is involved in the in the set up of new laboratory technologies, test and profiles related to Anti-Aging (AA) and functional medicine. She is always in communication with AA Doctors to help them in the decision of which are the best tests to ask and how to interpret results in each case/ patient. She received her Master in Pharmacy from Barcelona University (1988). Also received the Doctor of Pharmacy in Barcelona (1998); her doctoral thesis was focussed in the nutrition status of the Catalan population. She has the speciality on Drug analysis from the Barcelona University (2002). Anti-Aging Specialization from the University centre of Charleroi (2005). Dra. Sabater after finishing her Master in Pharmacy went through different internships in the FDA at Washington DC, FDA Chicago District Laboratory, Lancaster Laboratories and Comonwealth of Virgina laboratory. At Sabater Analysis she has been many years involved in different analytical departments, doing directly food analysis, vitamins, pesticide residue, metals, drug analysis. Also as Quality Manager. Presently she is a professor of the Master of AA at the “Universidad Autonoma de Barcelona” and in the “Universidad Nacional AutÛnoma de Mexico”. She has participate as speaker in several SEMAL AA congress, AA courses, and in the “ 1 er Foro Internacional de Medicina EstÈtica y Antienvejecmiento” in Mexico. She is a member of

SEMAL (Spanish society of AA medicine) and the European Academy of AA medicine. She has been recently nominated to belong as corresponding member of the Royal Academy of Pharmacy of Catalonia.

Dr. Andreas Roumbas

DR. ANDREAS ROUMBAS was born in 1963 in Cyprus. He finished his studies in Minsk Belarus in General Medicine in 1989, and worked and practiced in General Surgery from 1989 until 1995. Graduated with the degree of PhD in 1995 after his studies in decompression of bowel with three international patents for this study. He authored ten medical books issued in Belarus, with a lot of monografies in bowel decompression.He is a Member of Association of Extracorporal Methods of Detoxication and he was trained in Germany and Italy in Liver transplantation for three years.He also practiced in Surgery, which involved in Laser Therapy from 1992 with CO2 and then with other lasers like Nd:Yag, Erbium and well known KPT technology and treatment.He trained lot of colleagues to use lasers most of them from Greece and Greek islands.

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Prof. Dr. Farouk A.H. Al-Watban, M. Sc., Ph.D. FASLMS

Profession & SpecialtyLaser Technology & Applications, Consultation, Research, Services, Training, Educations And SafetyPresent Employment Principal ScientistLaser Medicine Research SectionBiological and Medical Research Dept.King Faisal Specialist Hospital & Research Centre (KFSHRC)

President of World Association for Laser Therapy (WALT)Founder of the World Academy of Laser Application (WALA)Academic Educations (Degrees Earned)1978 Ph.D. University of Heriot Watt, Edinburgh, U.K.1975 M.Sc. University of St. Andrews, St. Andrews, U.K.1967 B.Sc. Baghdad University, College of Science IraqAcademic ThesesM.Sc. Thesis Magneto-phonon Effect in Lead Sulphide / published in: - St. Andrews University, Fife, Scotland, U.K. (1975).Ph.D. Thesis Ammonia Laser & its Solid State Applications / published in: -Heriot-Watt University, Edinburgh, Scotland, U.K.

(1978).Professional MembershipsSince 1986 Fellow American Society for Laser Medicine & Surgery (FASLMS), http://www.aslms.org1986 Member IPA International Photodynamic Association, http://www.ipa-net.org/1985 Consultant Islamic Foundation for Science Technology and Development, (IFSTAD), P.O.Box 9833, Jeddah 21423, Saudi Arabia.1982 Member European Laser Association – (ELA) Conjunction with European Medical Lasers Association (EMAL) Lenzhalde 91, D-70192 Stuttgart, Germany.1984 Member The-Franco-Arab Association for Medical Research in Laser & New Technologies, 36 Boulevard de Latour-Maubourg 75007, Paris, France (Seceded 1987).1984 Member Executive Editorial Board, KFSH&RC Medical Journal (Now Annals of Saudi Medicine), http://www.kfshrc.edu.sa/annals1999 Member Editorial Board, World Association for Laser Therapy (WALT), www.walt.nu1999 Life Member World Association for Laser Therapy (WALT)1999 Executive Regional Representative Laser Therapy Journal (The Journal of WALT)2004 Member Editorial Board Photo medicine and Laser surgery, http://www.liebertpub.com/2004 Member American Diabetes Association, Professional Section Membership Box 631762,Baltimore, MD 21263-1762 http://www.diabetes.org2006 Elected President of the World association for Laser Therapy (WALT), Brazil2007 Founder And President World Academy for Laser Applications (WALA)2006-2008 President for World Association for Laser Therapy (WALT)Certificates of Appreciation Awarded From1986 The First International Conference on PDT and Diagnosis, held in Tokyo, Japan.1988 The Board of Directors of the Laser Institute of America, U.S.A.1994 Al-Riyadh Biomedical Engineering Club for having a lecture offered to its member, Riyadh, KSA, 19941996 The Chairman, Of Organizing Committee, 1ST LASER Conf., Security Forces Hospital, KSA.2002 The Executive Director, Research Centre, for conducting a Laser Safety Training Course, KFSH&RC, 26-27 May 20022003 The Office of Prince Salman Bin Abdulaziz Al Saud, Riyadh, KSA, 13 December 2003.2006 Certificate of Special Tribute from the 6th Congress of World Association for Laser Therapy (WALT), Limassol, Cyprus, 25-28 of October 2006

Dr Hugues Cartier MD

who is the President of the French Society of Aesthetic and Dermatological Surgery and a board member of the French Dermatological Laser Society. Dr Cartier has more than 7000 before and after photographs proving the clinical efficacy of the Pulsar on Hair Removal, Photo Rejuvenation, Scars, andPigmented and Vascular lesions.

Dr Jean-Pierre Naim

Born in 1955,Dr Jean-Pierre NAIM is Belgian,and graduated from the University of Brussels (Belgium),school of medicine,in 1980.Board certified in Family Medicine in 1984.He has been practicing Internal and Family Medicine in Belgium,Lebanon ,France and Switzerland for the last 25 years.Currently,he is leading the medical service of an Inernational Geneva-based specialised UN agency.Dr NAIM committed himself to complementary medicine since 1990.He earned many scientific prices and awards .He has incorporated nutrition and natural health techniques into his clinical practice .He published extensively in the medical litterature and has lectured around the world in particular,on longevity,anti-aging,cardio-vascular ,neuro-degenerative diseases,nutrition,infectious diseases,environmental medicine ,obesity,diabetes,and aesthetics.Dr NAIM is the founder and former president of the Swiss Academy of Anti-Aging Medicine SAAAM,a non profit association.At present,he is the head of the medical and scientific Board of SAAAM.He is member of several societies.He published many studies on the impact of chemical toxins and pesticides on health.He is a very well known International lecturer and wrote many papers in different medical magazines,mainly on Integrative and environmental medicine.

Dr. Daniela Taher (Lebanon)-Private practice, medical director of Derma Center-Tripoli, Lebanon (laser and cosmetic dermatology center)-Founder member and secretary of Middle East Society of Dermatologis Surgery (MESDS)-Member of International Society of Dermatologic Surgery (ISDS)-Presently Secretary of Middle East Society of Dermatologis Surgery (MESDS)

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Dr. Cristian Niţescu

Medic primar chirurgie plastică şi microchirurgie reconstructivăCercetător ştiinţific principal gradul IIIDoctor în Ştiinţe MedicaleDirector medical Spitalul Clinic de Chirurgie Plastica, Reparatorie si ArsuriSef sectie Chirurgie Plastica - Lasermed Medical Center

Cursuri de perfecţionare:1. “Fracturile deschise de gambă”- Prof. Dr. I. Lascăr, Spitalul de Urgenţă Floreasca, 19942. “Noţiuni fundamentale de microchirurgie” - Prof. Dr. I. Lascăr, Spitalul de Urgenţă Floreasca, 19943. “Tehnici microchirurgicale” – Conf. Dr. C. Ciuce, Clinica Chirurgie II, Cluj-Napoca, 19964. “Tehnici în chirurgia estetică” – Prof. Dr. Fl. Isac, Spitalul Clinic de Chirurgie Plastică Reparatorie şi Arsuri Bucureşti, 19975. “Chirurgia estetică a sânului” - Prof. Dr. Fl. Isac, Spitalul Clinic de Chirurgie Plastică Reparatorie şi Arsuri Bucureşti, 19986. “Chirurgia siluetei” - Prof. Dr. Fl. Isac, Spitalul Clinic de Chirurgie Plastică Reparatorie şi Arsuri Bucureşti, 1999.7. “Antiaging concept” – American Academy of Anti-Aging Medicine & European Academy of Anti-Aging Medicine, Paris, 2004.Apartenenţa la Societăţi Ştiinţifice:· Societatea Română de Chirurgie Estetică – din 1993.· Societatea Română de Chirurgie Plastică, Reparatorie şi Arsuri, 1992-2004.· Asociaţia Română a Chirurgilor Plasticieni – din 2004.· Cofederaţia Internaţională de Chirurgie Plastică, Reconstructivă şi Estetică (IPRAS) – din 1997. · Societatea Europeană de Arsuri (EBA) – din 1995.· Societatea Română de Microchirurgie Reconstructivă – din 1996.· Societatea Română de Chirurgie a Mâinii – din 1996.

Dr. Bogdan Dimitrie Niculae, MD, Bsc, MBA

College: High School "Gheorghe Lazar" from 1981 to1985University: Medical University – Carol Davila from 1987 to 1993Post-graduated qualifications: · N.Gh.Lupu Universitary Hospithal- Bachleor of Science in Dermatology and Venerology from 1993 to 1996· Instituto Medico Villafortuny – Barcelona, Spain - 1995· Lasercare Clinics- London, UK- 1996· ASLMS – Skin Resurfacing courses-San Diego California, USA -1998· Medicom – Laser Therapy Courses – Czech Republic -1998 · EMLA- Lasers in skin surgery courses – 1998

· Lecturer at the National Congress of Dermatology - organized the first laser course for dermatologists- “Lasers in Dermatology”- Neptune, Constanta, -1998· Lecturer at the National Congress of Dermatology - organized the second laser course for dermatologists-“New approaches in laser skin surgery”- Bucharest, -1999· Lecturer for the Pro-Laser Foundation -organized laser courses for medical doctors from Romania- Bucharest, -from 1996 until 2000 (over 400 attendees)· Chief of Project- Developing and manufacturing the first medical laser devices from Romania “DIOLZR”under the Pro-Laser Foundation from 1998 to 2000· Member from 1996 and Fellow from 2001 in American Society for Lasers in Medicine and Surgery· American Society for Lasers in Medicine and Surgery – Skin Rejuvenation & Skin Resurfacing courses- Edinburgh, UK- 2003· American Society for Lasers in Medicine and Surgery – Vascular lesions courses- Edinburgh, UK- 2003· American Society for Lasers in Medicine and Surgery – IPL & Hair removal courses- Edinburgh, UK- 2003· Anti-Aging World Congress – Las Vegas – USA-, 2004,2006· Lecturer for Rofill , Holland– Peelings , Non-permanent and permanent fillers courses held in Cyprus, Lebanon, Romania- 2004· American Society for Lasers in Medicine and Surgery – Avoiding Complications in Laser Surgery course – Boston , USA -2006· American Society for Lasers in Medicine and Surgery – Skin Rejuvenation course – Boston , USA -2006 · Romanian Anti-Aging International Congress 2005, 2006 – President of the Organizing Comitee · European Anti-Aging Medicine Association- Member of the Board- Audit Comission from 2006· HARVARD MEDICAL SCHOOL -Department of Continuing Education - Laser & Aesthetic Skin Therapy: What's the truth? – Masachusetts General Hospital – Boston , USA – 2007· World Congress of Anti-AgingMedicine - Monte Carlo, France 2007- International Board of The Scientific Organisation Committee· Member of THE PHILALETHES SOCIETY from 2003

Published various scientific articles, co-author of first Romanian textbook “LASERS IN DERMATOLOGY” and “THERAPEUTICAL LASERS”.WORK EXPERIENCE· From 1993 to 1996 - the President of Pro-Laser Foundation, and Chief Editor at the foundation magazine “Lasers in Medicine”· From January 1993 to 2000 I was founder and Executive Director at the first Romanian Medical Laser Center named LASERMED· From 2000 to now founder and General Manager at the Medical Laser Center named LASERMED Medical Services · President and Founder of Romanian Anti-Aging Medical Association from 2004· Chief Editor of The ROMANIAN ANTI-AGING MAGAZINE from 2006

Angelika Zigan

My school time and the first years of work I spend in my native country. Since 1 and a half year I am living in Hungary and working for Biolitec AG. Twardy a private German company hire me in 1985 selling medical devices after that I was working for Sandoz, Novartis, Grünenthal always as a sales for medical products and drugs. 5 years ago Biolitec AG gave the job as key accountmanager to me and I started with Foscan a drug against cancer. Now I am responsible for esthetic products including laser liposuction, the reason why I am here. In my area - south east Europe - traveling is proper because the people are politely and the weather is optimally so I bought a home some month ago. In aspiration of a good collaboration.

Miklós Antal

I got school certificate at the Telecommunication High School Budapest.Between 1971 and 1982 I worked as telecommunication Ingeneur at the Radio and TV Broadcasting Dept. of the Research Institute of the Hungarian Post. 1982 and 1989 I worked as service engineer in lnterelektronik Instrument Measurement Technology Group. From 1992 I have worked at the ANAMED Ltd as service engineer, and service manager. My job was to and install the medical instruments, to train the end user's staff to do instrument maintenance and repair. I am thus fully acquainted with the instruments and equipment manufactured by KONTRON Instruments, HAMILTON, Graseby Medical and BCI.From 1999 I'm the representative at the Biolitec AG in middle Europe about the Diodelasers., Fibers and application, in the speciality like Dental, ENT, Gastroenterology, Plastics surgery and Urology.

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This study describes issues generated by visual and hearing impairment, linked to physical and psycho-social functioning. Materials and Methods:A sample of 332 inpatients was selected, based on their sensorial impairments -131 men and 201 women, with the average age, 76.3 years. The questionnaire used (medico)-psycho-social instruments as: Visual Functioning Screening Questionnaire (Horowitz, A., 1998); Five Minutes Hearing Test (1993); PAS Depression Scale (Jorm, Mackinnon, 2000); Stress Assessment Scale, Brief Screen for Cognitive Impairment (BSCI).Results:The correlations between the visual and hearing screening scores with: -the stress level, -the number of major stresses and –the subjects' depression score, showed that elderly persons worried more related to visual loosing and less to hearing loosing. The percent of double sensorial loss was high: 60%. Also, the work pointed out lesser stress in the group with one sensorial deficiency, and higher stress at those with double affection. Linear regression analysis explained the level of stress, in the first group, through the variables: depression, co-morbidity and the number of ocular diagnosis. In the group with both visual and hearing loss, predictors for higher stress were: depression, co-morbidity, cataract frequency and cognitive impairment. Conclusions:The work reveals: - the influence of visual and hearing impairment on the quality of life of the elderly, observed from a physic and psycho-social viewpoint, and - the importance of prevention: primary (early diagnosis through screening), and secondary ( periodic assessment of sensorial function, as well as adequate therapy which are mandatory for preventing or limiting sensorial loss).

Double Sensorial Impairment, Cause of a Greater Stress for Elderly Persons

In studies of the specialized literature we find quite often the notions of healthy elderly patient and healthy aging which are not clearly defined from the scientific point of view of a likely demarcation between physiology of age and physiopathology. In order to start a debate as related to this topic, we opted for a case presentation of an elderly patient L.E., 93 years of age, with baccalaureate and higher education and who lost her spouse three years ago.This patient lives alone, manages on her own and has legal caregivers abroad. It was her own decision to come to be hospitalised. Her only complaints were dizziness and upper and lumbar back pains. She denied significant antecedents in her medical history.Our patient was looking extremely nice, engaged in conversation of a high intellectual quality, she was reading books both in Romanian and French. This elderly woman was oriented in space and time, extremely active, telling her doctor that she was practicing daily physical exercises for half an hour (bycicle and stepper) without getting tired or having trouble breathing.Taking into account the lack of major physical complaints, her excellent health condition and also her denial of medical history significant antecedents, the physician examining her at first was impressed as by an healthy elderly person. Results of the clinical biochemistry panel, hematological testing and paraclinical investigations, blood pressure, ECG, HOLTER, EEC, oscillometry, abdominal ecography, radiology for upper and lumber back, psychological questionnaire pointed out severe diseases present. Of these, the most important was the coronary disease with significant sequel of a myocardium infarction and high values for the blood pressure 200/100 as well as peripheral obliterant artery disease.We suggest to carefully reflect on presentation of this case and recommend using the notion of apparently clinically healthy elderly individual because under the likeness of a good health condition and a degree of self management to envy at this age, there might be serious diseases that can be fatal.

DoinaRoditis The National Institute of Gerontology and Geriatrics-“Ana Aslan”, Bucharest

Healthy aging between myth and realityR Pircalabu, I Raducanu, R.Hnidei, B.Morosanu, R Nacu

INGG “Ana Aslan”

Mood particularities in postmenopauseR Pircalabu, I Raducanu, R.Hnidei, B.Morosanu, R Nacu

INGG “Ana Aslan”

Numerous studies have demonstrated that menopause does not induce onset of a major depressive disorder, although an episode could be evident in patients with psychiatric antecedents. Course to onset of menopause is nonetheless accompanied by a depressive mood.Insomnia is in most cases strongly correlated with nocturnal hot flushes, which when they appear along with profuse perspiration lead to onset of insomnia.According to the SWAN study, Caucasian women present with sleep disorders more frequently than theAfro-American women, while memory and difficulties to concentrate have been pointed out for Hispanic women.After the onset of menopause women can have deficits of memory and in concentrating. Some authors hypothesized that the estrogen deficit is implicated in the pathogenesis of the Alzheimer's disease and the hormone replacement treatment could lead to lowering this disease incidence. This hypothesis is a controversy as it is not accepted by many authors.In a study that was awarded a grant from the Romanian Academy, we estimated the depressive mood in postmenopausal women with ages between 50 and 65 years.After carrying out an analysis of scores by calculating results of depression self-evaluation questionnaires, a majority percent of 61% women who entered this study has depressive moods.Further carrying out this study by increasing the number of subjects could point more objectively toward the degree to which the mood is affected in postmenopausal women as well as the main risk factors generating the depressive mood. So, a strategy of prevention and treatment can be established taking into account that the depressive mood can in turn become a risk factor for cardiovascular diseases and onset of a cognitive impairment.

A series of results with regard to both antioxidant enzyme activity changes and variables influencing the aforementioned modifications have been less consistent in our works and with an extremely variable range of normal values. On the other side, international studies using newer technologies have already attempted to explain modifications of the antioxidant enzyme activities by associations with gene polymorphism. This work aim is questioning whether our further research that regards the antioxidant defense could be limited by not considering antioxidant enzyme gene polymorphisms. A couple of recent studies described the human erythrocyte glutathione peroxidase polymorphism GPX1 Pro198Leu that correlates with low GPX1 activities in women with breast cancer. Nonetheless, in these women patients GPX1 activities are decreased but not significantly low. In men with alcohol induced cirrhosis, the low enzyme activity associated with the polymorphisms GPX1 2Leu and GPX1 1Pro 1Leu, when only combined with the polymorphism manganese superoxide dismutase MnSOD-Val, possibly modulate the risk of developing heptocellular cancer. Conclusion: Studies of the specialized literature likely have pointed toward a relative contribution of gene polymorphism as influencing the antioxidant enzyme activities. So, further we should invariably take into account non-genetic variables, interventions and various factors affecting the antioxidant function even though our means are insufficient for mining data of the aforementioned variables. Also, if we are to approach enzyme gene polymorphism testing, both carrying out research in a large number of individuals and costs for genetic tests pose problems.

Endogenous antioxidants and genetic risk factors

Cristina Ionescu, Elena Lupeanu

The National Institute of Gerontology and Geriatrics-

“Ana Aslan”, Bucharest





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Human blood precursors differentiation from umbilical cord blood in beta-insular pancreatic cells.

Catalina Monica Pena, Octavian-Gabriel

Olaru, Crina Amalia Carazanu

In recent years, human umbilical cord blood (HUBC) has emerged as an attractive tool for cell-based therapy. Although at present the clinical application of HUBC is limited to the fields of hematology and oncology, a rising number of studies show potential for further application in the treatment of non-hematopoietic diseases. HUBC, with its real abundance, simple non-invasive collection procedure and no serious ethical dilemmas represents a valuable alternative to the use of other stem cell sources.One of the major challenges in stem cell research is to increase transpantable HSC number by stimulating self-renewal divisions of hematopoietic stem cells ex vivo in order to expand the primitive compartment and precursor cells. The ex vivo expansion of hematopoietic stem cells is a very promising approach for different clinical applications. In this respect, stem cell-rich umbilical cord blood represents a promising and so far inadequately studied therapeutic tool. Important steps toward succesful development of an (ES) cell – based therapy include the establishment of a protocol that would allow for (ES) cells to differentiate into a particular cell type of interest and a means by which such a lineage of cells could be separated from the mixed population and enriched. Amongst the various therapeutic approach cell therapy is promising due to its possible curative potential. For these reasons it is very important the potential for converting HUCB-derived stem cells into insulin-producing beta-cells. In conjuction with the application of HUCB for diabetes treatment, the observation that bone marrow-derived cells may become insulin-producing cells is of enormous importance. Since the HUCB-derived unrestricted somatic stem cell share most of the cell markers and properties with multipotent adult progenitor cells, it should be considered that HUCB may contain cells with a potential to develop into insulin-producing cells.

Olfactory function is markedly altered in old age and in a number of age-related diseases. The literature reports that ageing is accompanied by olfactory loss and hyposmia/anosmia, which is also a feature of several neurodegenerative disorders. The olfactory loss may cause loss in quality of life due to food-related problems. The olfactory nerve provides a direct anatomic conduit between the external chemical environment and the brain. This location puts the olfactory system at risk for damage from environmental toxicants and pathogens. These toxic agents comprise the major health hazard to human olfaction. However, the direct and indirect effects of these agents on the peripheral and central olfactory system are poorly understood. Neurotoxic heavy metals can also penetrate the brain by that way, promoting anosmia, that is the loss of olfactive ability, and neurologic disorders related to Alzheimer's and Parkinson's symptoms. Even if relatively high protective drug metabolizing enzyme activities should afford a protection to the olfactory bulb, olfactory neurons may undergo toxic damage by direct exposure to environmental pollutants. Fortunately, as the olfactory epithelium possesses high biotransformation activities catalysed by cytochrome P450, UDP-

Molecular mechanisms of ageing in the rat olfactory system

Daniela GradinaruThe National Institute of Gerontology and Geriatrics-“Ana Aslan”, Bucharest

glucuronyltransferases (UGT) isoforms, and glutathione S-transferases, it should represent a first line protection of the brain against air-borne xenobiotics. Therefore, in the present work are reported data regarding the glucuronidation potential of rat olfactory bulb toward odorant compounds, during animal development and ageing. Also, by Western blot and reverse transcription-polymerase chain reaction (RT-PCR), is demonstrated the presence in the olfactory bulb of the UGT1A6 isoform, which catalyses the glucuronidation of phenols, such as 1-naphthol. The present results suggest that the age-dependent changes in glucuronidation activity are not the result of modifications in UGT1A6 expression.

AbstractThe paper brings forward the importance of using health informatics systems in the anti-aging domain. Aging well in the modern society is a social necessity and Information and Communication Technologies (ICT) responds positively to the demographic challenge. The new age composition of the European society will place high demands on the health and long-term care sector, which will inevitably result in rising costs. In order to limit the cost explosion and to be able to serve the needs of a growing number of elderly people, healthcare systems need to become more effective and efficient. The use of ICT can be one of the main drivers for higher efficiency and effectiveness in the healthcare sector; that can offer new services like the possibility of disseminating and sharing information or knowledge, because information is the basis of a well-functioning health system. “Multidisciplinary Complex System for the Efficient Management of the Anti-Aging Information” (AgingNice) is a complex system that responds to these desiderata and it has as target to achieve a modern informatics tool able to centralize in a single point with stratified access a variety of web services and information classified by the user's type (ordinary citizens and professionals), with long term benefits for person and society.AgingNice demonstrates that the information technologies have a deep integrator character, both at the level of the information management and at the one of the development of the modern health systems, putting efficiently into value the opportunities offered by a fast accessibility. IntroductionThe European society is aging. The share of elderly people in the total population will rise dramatically in the next decades. From 2005 to 2030 the number of people in the age group 65+ will rise by 52 % or 40 million, while the age group of 15-64 will decrease by about 7 % or 20,8 million. The total EU-25 population is expected to grow from 450 million in 2000 to 470 million in the year 2025. After this, the population is likely to decrease to 449 million in 2050.[1] Anti-aging represents a new concept that tackles the body health from another perspective – the one of preventing and treating the degenerative diseases with a therapeutic protocol elaborated by a team containing all of medical specialties. The result consists in the delaying of the aging process and restoring the vitality of the mature body, but also an aesthetic appearance that harmonizes

Multidisciplinary Complex System for the Efficient Management of the Anti-Aging Information (AgingNice)

Marilena Ianculescu, Monica Pârvan, Horia Paunescu,Laurentiu Coman, Oana Andreia Coman





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with everybody's wishes.Health promotion for the increasing aging population is an urgent and essential task because evidence indicates that health promotion interventions can extend longevity and improve quality of life. Health informatics systems can play an important role in achieving wellbeing, independent living and delaying of the aging process and restoring the vitality of the mature body. [2]The initiative i2010 “European Information Society for growth and employment” encourages the development of an open and competitive digital economy and emphasises ICT as a driver of research and creating of partnership in ehealth for providing high quality public services. [3]rThe multidisciplinary complex system AgingNice belongs to the health informatics systems with particularization in the anti-aging domain and allows the sharing of the knowledge concerning the specific research and the promotion of the theoretical and practical information, both among the stakeholders from the medical area and at the person level. It comprises an interconnected database system concerning anti-aging methods and strategies, clinical and laboratory investigations for aging preventing, anatomical modifications, educational models, self-evaluation tests, defining a personalized demeanor, tendencies in the anti-aging biomedicine, anti-aging campaigns and also applications for facilitating the dissemination of the therapeutic protocol, study cases and recent research among the specialists from la large range of medical domains. [4]AgingNice is a research project developped inside the National Research, Development and Innovation Plan for the period 2007-2013 (NP II) is the main instrument by which the Romanina National Authority for Scientific Research (NASR) is implementing the National Strategy for RDI.ObjectivesThe main objectives can be synthesized like this:· creating an environment able to facilitate the knowledge, information and date circulation aiming an efficient management of the anti-aging domain;· supporting and motivating the actuality of the anti-aging concept and increasing the quality in health systems;· developing the informational space of the Romanian state of health;· putting into value the advantages offered by ICT regarding the accessibility of the information in the anti-aging domain.

MethodsAgingNice is created due to a partneship which ensures a multidisciplinary collaboration among divers categories of physicians, biologists, IT specialists and researchers, a key element

for an efficient management of the anti-aging domain.The complex system contains a great variety of applications that covers the proposed objectives. It has an architecture that is structured into modules, allowing that new functionalities could be easily added, without damaging the existing components or having to reorganize the existing data from the system. The information is stored in databases available via Internet permanently updated by specialists.The problem of the accessibility is solved by using a web-based solution, a web browser being the only necessary condition for the user to connect to a system, with no need for other applications. It is a system characterized by modularity, flexibility, platform independence, dynamism, accessibility, multidisciplinarity, interoperability and it respects the main tendencies of developing the health informatics systems. The security of the information is ensured by a divided hierarchical access at the system' function s and informational resources. The performances of this system take into consideration the user-friendly interface, safety functioning, running and data, high response time. It is envisaged the possibility of migrating the system towards a next generation technology since the designing.

ResultsThe projects aims to obtain the following results:· application for defining a personalized demeanor and age management;· application for elaborating self-evaluation tests on which educational models are established;· applications for presenting relevant research in the biotechnology domain concerning aging mechanisms, the anti-aging evaluating methodologies;· application that synthesizes the factors that arouses the age degenerative processes;· application that presents the essential anatomical modifications related with the age;· application for creating relations among actual anti-aging methods and strategies at a person's level;· application dedicated to prevention by clinical and laboratory investigations for revealing precocious aging and anti-aging campaigns;· application comprising comparative and correlative analysis concerning anti-aging products (nutritive supplements, cosmetic products etc);· application for facilitating the dissemination of the therapeutic protocol and study cases;· application for offering online personalized advice;· applications for the ordinary citizen aimed to develop the knowledge, the comprehension and the habits that encourage the changing of the individual behavior;· applications for the specialists targeted to create an environment for informing and collaboration;· application for monitorizing the correlation among involved medical specialties: anti-aging, allergology, cardiology, dermatology, endocrinology, geriatrics, medical cosmetics etc.The system brings an important contribution to the development of the anti-aging knowledge because it leads to: · the improvement of the specialized knowledge and the professional skills for increasing the performances, · the integration of the research, education and training activities with information technologies, · the changing of the attitude towards the age management,





the intensification of the collaboration among convergent specialties for considering thoroughly the anti-aging domain, the facilitation of the communication among the professionals and between those and the citizens.

DiscussionsThe use of the information technology in Romania in the anti-aging domain is insignificant and it doesn't cover the specialists' demands and the citizen's need of informing. By presenting cosmetics products, the existing web applications in this area center with priority on the aesthetic aspects of the aging. The physicians are interested in a domain with such implications, but they don't have access to recent and centralized information. The stakeholders at the society level haven't elaborated yet a perspective strategy concerning the prevention in this domain.AgingNice, with the help of information and communication technology, will have a great penetration in all the structures of the society and it will try to make aware the citizens, the specialists and the legal organizations about the importance of knowing the anti-aging domain under all its aspects and acting properly.

Conclusions AgingNice is an informatics tool that, in the context of the increased and constant getting older of the population, contributes at the optimization of the prevention methods and strategies for a healthy aging. In the same time, by creating the frame and the opportunities for a multidisciplinary collaboration among the specialists that are concerned about the anti-aging domain, by making popular the medical information at the citizen level it raises the awareness, and shares the understanding and common approaches. Such health informatics system covers the insignificant use of the ICT in the anti-aging domain, emphasizing the information presentation done as understandable as possible and the adaptation of the communication strategy to the targeted beneficiary's response and needs.References[1] EC Green Paper “Confronting demographic change”[2] J. Levet, Health, Information Society and Developing Countries (Studies in Health Technology and Informatics, 2004 Publisher: IOS Press[3] i2010 - A European Information Society for growth and employment;http://ec.europa.eu/information_society/eeurope/i2010/index_en.htm[4] “Multidisciplinary Complex System for the Efficient Management of the Anti-Ageing Information”, Scientific Report 2007, National Institute for R&D in Informatics

Utilizarea TIC poate fi unul din motoarele pentru o eficienţă şi competenţă ridicate în sectorul sănătăţii. Acestea pot oferi noi servicii, cum ar fi posibilitatea de diseminare şi partajare a informaţiilor şi cunoştinţelor, având în vedere că informaţia reprezintă baza unui sistem de sănătate optim.“Sistemul complex multidisciplinar pentru eficientizarea managementului informaţiilor anti-aging” (AgingNice) este un sistem complex care răspunde acestor deziderate şi care are drept ţintă realizarea unui instrument informatic modern care centralizează într-un singur punct cu acces stratificat o varietate de servicii web şi informaţii clasificate în funcţie de tipul utilizatorului (cetăţean obişnuit sau specialist), cu beneficii pe termen lung pentru individ şi societate.AgingNice demonstrează faptul ca tehnologia informaţiei are un caracter profund integrator, atât la nivelul managementului informaţiei cât şi la cel al dezvoltării sistemelor de sănătate moderne, punând eficient în valoare oportunităţile oferite de accesibilitatea rapidă.

IntroducereSocietatea europeană îmbătrâneşte. Procentul persoanelor în vârstă din totalul populaţiei va creşte în mod dramatic în următoarele decenii. Din 2005 până în 2030 numărul celor cu vârsta de peste 65 ani va creşte cu 52% (40 milioane), în timp ce grupa de vârstă de 15-64 ani va descreşte cu aproape 7% (20,8 milioane). Se preconizează ca totalul populaţiei Europei să crească de la 450 milioane în 2000 la 470 milioane în 2025. După aceea populaţia va descreşte la 449 milioane în 2050.[1] Anti-aging reprezintă un nou concept care abordează sănătatea organismului dintr-o altă perspectivă – aceea de a preveni şi trata bolile degenerative printr-un protocol terapeutic elaborat de o echipă din care fac parte toate specialităţile medicale. Rezultatul constă în întârzierea procesului de îmbătrânire şi redarea vitalităţii organismului ajuns la maturitate, dar şi a unui aspect estetic care să concorde cu dorinţele fiecăruia dintre noi.Promovarea sănătăţii pentru populaţia care continuă să îmbătrânească este o problemă urgentă şi esenţială deoarece experienţa arată că acţiunile de promovare a sănătăţii pot mări durata de viaţă şi îmbunătăţi calitatea vieţii. Sistemele informatice de sănătate pot juca un rol important în prelungirea vieţii active şi independente, întârzierea proceselor de îmbătrânire şi refacerea vitalităţii individului. [2]Iniţiativa i2010 “European Information Society for growth and employment” încurajează dezvoltarea unei economii digitale deschise şi competitive şi scoate în evidenţă faptul că TIC este elementul cheie al cercetării şi creării de parteneriate în ehealth pentru realizarea unor servicii publice de înaltă calitate. [3]Sistemul complex multidisciplinar AgingNice face parte din aria sistemelor informatice pentru sănătate cu particularizare în domeniul anti-aging şi permite partajarea de cunoştinţe privind cercetările specifice precum şi promovarea informaţiilor teoretice şi practice atât între factorii de decizie din zona medicală, cât şi la nivel de individ. El cuprinde un sistem de baze de date interconectate privind metode şi strategii anti-aging, investigaţii clinice şi paraclinice pentru prevenirea îmbătrânirii, modificări anatomice, modele educaţionale, teste de auto-evaluare, definirea unei conduite personalizate, tendinţe în biomedicina anti-aging, campanii anti-aging, precum şi aplicaţii pentru facilitarea diseminării protocolului terapeutic, a studiilor de caz şi a cercetărilor recente între specialişti dintr-o gamă largă de domenii medicale.[4]AgingNice este un proiect de cercetare dezvoltat în cadrul Planului Naţional de Cercetare, Dezvoltare şi Inovare pentru perioada 2007- 2013, care reprezintă principalul instrument prin care

Sistem complex multidisciplinar pentru eficientizarea managementului informatiilor anti-aging (AgingNice)

Marilena Ianculescu, Monica Pârvan, Horia Paunescu,Laurentiu Coman, Oana Andreia Coman

Lucrarea scoate în evidenţă importanţa utilizării sistemelor informatice de sănătate în domeniul anti-aging. A îmbătrâni frumos în societatea modernă reprezintă o necesitate socială, iar Tehnologia Informaţiei şi Comunicării (TIC) răspunde pozitiv la provocările demografice. Noua structurare pe vârste a populaţiei în societatea europeană va conduce la cerinţe ridicate în sectorul sănătăţii şi a îngrijirii pe termen lung, care vor implica în mod inevitabil costuri ridicate. Pentru a limita explozia cheltuielilor şi pentru a servi necesităţile unui număr crescând de persoane în vârstă, sistemele de îngrijire a sănătăţii trebuie să devină mai eficiente şi mai competente.

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Autoritatea Naţională pentru Cercetare Ştiinţifică implementează Strategia Naţională pentru CDI.ObiectiveObiectivele principale pot fi sintetizate astfel:· crearea unui cadru care să faciliteze circulaţia de cunoştinţe, informaţii şi date cu scopul unui management eficient al domeniului anti-aging;· susţinerea şi argumentarea actualităţii conceptului de anti-aging şi creşterea calităţii în sistemele de sănătate; · dezvoltarea spaţiului informaţional al sănătăţii româneşti; · valorificarea în domeniul anti-aging a avantajelor oferite de TIC privind accesibilitatea informaţiilor.MetodeAgingNice este realizat în cadrul unui parteneriat ce asigură o colaborare multidisciplinară între diverse categorii de medici, biologi, informaticieni şi cercetători, element cheie pentru un management eficient al domeniului anti-aging. Sistemul complex conţine o mare varietate de aplicaţii care acoperă obiectivele propuse. El are o arhitectură modulară, ce poate fi uşor extinsă cu noi funcţionalităţi, fără a perturba componentele existente şi a cere reorganizarea datelor existente din sistem. Informaţiile sunt stocate în baze de date apelabile Internet şi care sunt permanent actualizate de specialişti.Problema accesibilităţii va fi rezolvată prin folosirea unei soluţii bazate pe web, singurul lucru necesar utilizatorului pentru a se conecta la sistem fiind un browser de web, fără a fi necesare alte tehnologii.El se va caracteriza prin modularitate, flexibilitate, independenţă de platformă, dinamism, accesibilitate, multidisciplinaritate, interoperabilitate şi va respecta principalele tendinţe de dezvoltare a sistemelor informatice dedicate sănătăţii. Securitatea informaţiilor este asigurată printr-un acces ierarhizat pe roluri la funcţiile şi resursele informaţionale ale sistemului.Performanţele acestui sistem au în vedere interfaţa user-friendly, siguranţa în funcţionare şi exploatare, securitatea datelor, timpii de răspuns ridicaţi. În decursul proiectării se prevede posibilitatea migrării sistemului către o tehnologie din generaţia următoare celei folosite.Proiectul demonstrează că tehnologiile informaţiei au un profund caracter integrator, atât la nivelul managementului informaţiei, cât şi la cel al realizării efective a sistemului complex, valorificând eficient oportunităţile oferite de o rapidă accesibilitate.

RezultateSistemul informatic complex cuprinde următoarele aplicaţii:· aplicaţie pentru definirea unei conduite personalizate şi managementul vârstei;· aplicaţie pentru elaborarea de teste de autoevaluare pe baza cărora se stabilesc modele educaţionale;· aplicaţii pentru prezentarea unor cercetări relevante din domeniul biotehnologiei privind mecanismele îmbătrânirii, a metodologiilor de evaluare anti-aging;· aplicaţie care sintetizează factorii care provoacă procesele degenerative datorită vârstei;· aplicaţie care prezintă modificările anatomice esenţiale legate de vârstă;· aplicaţie de interelaţionare a metodelor şi strategiilor actuale anti-aging la nivel de individ;· aplicaţie dedicată prevenţiei prin investigaţii clinice şi paraclinice pentru decelarea îmbătrânirii precoce şi campanii anti-aging;· aplicaţie cuprinzând analize comparative şi corelative privind produse anti-aging (suplimente nutritive, produse cosmetice etc);· aplicaţii privind facilitarea diseminării protocolului terapeutic

· aplicaţii privind facilitarea diseminării protocolului terapeutic şi a studiilor de caz; · aplicaţie pentru acordarea online de sfaturi personalizate;· aplicaţii dedicate cetăţeanului obişnuit destinate să dezvolte cunoştinţele, înţelegerea şi deprinderile care favorizează schimbarea comportamentelor individuale;· aplicaţii dedicate specialiştilor pentru crearea unui mediu de informare şi colaborare;· aplicaţie pentru monitorizarea corelării între specialităţile medicale implicate: anti-aging, alergologie, cardiologie, dermatologie, endocrinologie, geriatrie, cosmetică medicală, medicină internă etc.

AgingNice va aduce o importantă contribuţie la dezvoltarea cunoştiinţelor prin faptul că va conduce la: · îmbunătaţirea cunoştinţelor de specialitate şi a abilităţilor profesionale pentru creşterea performanţelor, · integrarea activităţiilor de cercetare, de educaţie şi instruire cu tehnologia informaţiilor, · schimbarea de atitudine faţă de managementul vârstei, · intensificarea colaborării între specialităţi convergente pentru aprofundarea domeniului anti-aging, · facilitarea comunicării între profesionişti şi între aceştia şi cetăţeni. DiscuţiiÎn România utilizarea tehnologiei informaţiei în domeniul anti-aging este nesemnificativă şi nu acoperă cerinţele specialiştilor şi nevoia de informare a cetăţeanului. Aplicaţiile web existente în această zonă se axează prioritar pe aspectele estetice ale îmbătrânirii prin prezentarea de produse cosmetice. Medicii sunt interesaţi de un domeniu cu atâtea implicaţii, dar nu au acces la informaţii recente centralizate. Factorii de decizie la nivelul societăţii nu au elaborat încă o strategie de perspectivă privind prevenţia în acest domeniu. AgingNice, prin utilizarea tehnologiilor informaţiei şi comunicaţiei, va avea o mare penetrare în toate structurile societăţii şi va încerca să atenţioneze cetăţenii, specialiştii şi organismele statului asupra importanţei cunoaşterii domeniului anti-aging sub toate aspectele şi a acţionării în cunoştinţă de cauză.

ConcluziiAgingNice este un instrument informatic care, în contextul îmbătrânirii accentuate şi constante a populaţiei, contribuie la optimizarea metodelor şi strategiilor de prevenţie pentru creşterea calităţii vieţii şi a prelungirii perioadei active. În acelaşi timp, prin crearea cadrului şi oportunităţilor de colaborare multidisciplinară între specialiştii preocupaţi de domeniul anti-aging, prin popularizarea informaţiilor medicale la nivel de cetăţean şi prin facilitarea stabilirii unei legături mai profitabile între medic şi pacient se aduce o contribuţie importantă la eficientizarea sistemului de sănătate publică.Un astfel de proiect acoperă utilizarea nesemnificativă a TIC în domeniul anti-aging de până acum, punând accent pe prezentarea informaţiei cât mai pe înţeles şi adaptarea strategiei de comunicare, în functie de răspunsul şi nevoile beneficiarului căruia i se adresează. Referinţe bibliografice[1] EC Green Paper “Confronting demographic change”[2] J. Levet, Health, Information Society and Developing Countries (Studies in Health Technology and Informatics, 2004 Publisher: IOS Press[3] i2010 - A European Information Society for growth and employment; http://ec.europa.eu/information_society/eeurope/i2010/index_en.htm[4] “Multidisciplinary Complex System for the Efficient Management of the Anti-Ageing Information”, Scientific Report 2007, National Institute for R&D in Informatics· the improvement of the specialized knowledge and the professional skills for increasing the performances, · the integration of the research, education and training activities with information technologies, · the changing of the attitude towards the age management,

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Nowadays,Vitamin D deficiency is a major health concern worldwide.In reality,we can say that the situation currently is reaching the level of a silent epidemy with devastating health consequences.

Introduction and Vit D basics Vit D is synthesized in the skin in response to sunlight e x p o s u r e . S o m e f o o d s c a r r y v i t D l i k e w i l d salmon,tuna,sardines...and fortified milk.Aging skin is unable to synthesize Vit D.Extensive use of sunscreens and darker skins presents greater risks for VIT D deficiency.Longer winters and short days can lead to a shortage in VIT D. VIT D2 can be obtained from plants,but it's useless.VIT D is snthesized in the skin from it's precursor 7-dehydrocholesterol which is converted to cholecalciferol or VIT D3.In the liver,VITD3 is converted to 25-OH VIT D3,thereafter,the conversion to it's active form-1-alpha-25-di OH -VIT D3 will take place in the kidneys.Serum level of circulating VIT D (25-OH VIT D3) should be from 75-125 nmol /L

An overlooked epidemy Experts estimations: Billion individuals in the world are VIT D deficient..Leaving at high altitude is a major risk factor for VIT D deficiency.If not enough VIT D in the blood,only 10 to 15 cent of dietary calcium is absorbed and only 60%of phosphorous is bio-available.

VIT D lowers risk of death from any cause 18 trials:"intake of ordinary doses of VIT D supplements seems to be associated with a significant decrease in total mortality rates,from all causes"Trial on 1180 post-menopausal women :«VIT D IS A CANCER-PROTECTIVE AGENT,after 4 years ,the risk of contracting ANY cancer was 60% lower in the VIT D group!!....

HOW VIT D Prevents cancer: VIT D has a direct effect on more than 200 genes most of them are regulating cell proliferation,differentiation and programmed cell -death-Role of Vit D in protecting against prostate cancer...-Role of VIT D in the protection against Breast cancer...-Role of VIT D in the protection of colon cancer..

VIT D linked to lower CV Diseases: VIT D decrease blood pressure,increase insulin sensitivity and lowers inflammation.A US study on 1700 people ,average age 59,VIT D levels tested and follow-up for 7 years:those with low levels of VIT D below 15 nanograms/l had twice the risk of heart attack, heart failure,and stroke...

VIT D and diabetes: Higher VIT D levels are linked to lower diabetes risk.Study from Finland....:VIT D increase insulin sensitivity and decrease insulin resistance..

VIT D supports the immune system: VIT D is a powerful immune modulator agent.Receptors for VIT D are present in many cells of the immune system ,as NK cells ... flu in the winter,why?because of lack of VIT D

VIT D and aging: VIT D is impeaching the shortening of our telomeres...thus will help in slowing down the ageing process

VIT D PROTECTS AGAINST MS,RHUMATOID ARTHRITIS and Fibromyalgia: Scandinavian study:Women taking more than 1000 I.U/day of VIT D,have 42% lower cases of multiple sclerosis...

VIT D decrease chronic pain: Study of the American Anesthesiologists......

VIT D fights rickets in children,osteoporosis in the elderly,decrease fracture risk ,increase muscle strentgh ,improve the cartilage and joint functions,and make teeth solid

VIT D improve symptoms of the « seasonal affective disorder » SAD : Do not forget to supplement your patients suffering in the winter from SAD symptoms...studies...

VIT D prevents alcohol-related bone loss:

CONCLUSION

Optimising VIT D blood levels is a safe,low-cost way to protect against c a n c e r , d i a b e t e s , c a r d i o - v a s c u l a r d i s e a s e s , i m m u n e d isorder s ,os teoporos i s , r ikets , jo ints dys funct ion ,seasonal depression,chronic pain,alcohol-related bone loss among other serious health conditions.

VITAMIN D :NEW INDICATIONS AND NOVEL THERAPIES

Dr Jean-Pierre NAIMM.D, Geneva,Switzerland

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Objectives:In the present study we intended to look for the changes that occur in the hepatic tissue from histopathological point of view to the elderly patients at microstructural level and to compare them to the ultrastructural elements. Design:The encountered histopathological parameters were : inflammation , fibrosis , impairment of the local blood flow , deposition of lipofuscinic pigment .Participants: The study group included twenty five elderly pacients decedated in our clinic , selected by the criterion of no diagnosed liver disease . From these patients , we prelevated by post-mortem techniques , samples of hepatic tissue which were further processed by histopathological techniques and then , analised by optic microscopy. Results: In all studied cases , we encountered almost the same changes consisting in, preservation of the lobular architecture , presence of the intracellular deposits of lipofuscin , the portal inflammatory infiltrate the increase of the amount of connective tissue and the presence of lipidic vacuoles.We made some microphotographs too. Conclusions:The obtained results suggest that all the analised cases could be included in a normal evolution of the aging process sustained by the changes of the morphological background which could explain the progressive decline of the cellular functions .

Key words : elderly,histopathological,fibrosis

This work aimed to point out involvement of mitochondria and peroxisomes in modulation of oxidative stress intensity as associated with aging. Evaluation of oxidative stress status referred to the following measurements: 1)oxygen reactive species generation localized in mitochondria (NADH oxidation in the electron transport chain was stimulated with Fe (III)-EDTA), cytosol (xanthine oxidase activity) and peroxisomes (urate oxidase activity); 2) cellular antioxidant enzymes activities superoxide dismutase ( CuZnSOD), catalase and glutathione peroxidase (GPx); 3) oxidatively modified proteins (protein carbonyl groups). Experiments were conducted in healthy white Wistar rats of different ages. Investigations showed that in liver, kidney and myocardium mitochondria from old Wistar rats there was a significantly high stimulation of NADH oxidation induced by the Fe(III)-EDTA complex. As associated with aging, xanthine oxidase and urate oxidase activities increased significantly, whereas superoxide dismutase and glutathione peroxidase acting on H2O2 significantly decreased in liver, kidney and myocardium. Liver catalase from male rats significantly lowered, while in female rats increased significantly as associated with aging. In liver of old rats there was a significant increment in the content of oxidatively modified proteins. Mitochondria function alterations in the course of aging can be involved in enhancing the oxidative stress. This enhancement occurs because of a stimulation of oxygen reactive species production in mitochondria, cytosol and peroxisomes as well as lowered antioxidant enzymes activities.

Fibrotic and inflammatory changes in normal aging process in liver structureCrina Amalia Carazanu , Catalina Monica Pena The National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

ADVANCED OXIDATON PROTEIN PRODUCTS - MARKER OF OXIDATIVE STRESS IN AGING

Claudia Borsa The National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

Aging is associated with increased oxidative stress cause by an imbalance between antioxidant and oxidant-generating systems. Proteins are recognized as major targets of oxidants and the accumulation of oxidized proteins is a characteristic feature of aging. Advanced oxidation protein products (AOPP), final products of protein oxidation, are formed during oxidative stress by action of chlorinated oxidants resulting from myeloperoxidase activity. We investigated AOPP in healthy elderly subjects and their relations with other metabolic parameters. In vitro studies pointed out increased AOPP levels in a dose-dependent manner by exposure of serum collected from elderly to hypochlorous acid. In vivo, increased serum levels of AOPP were found in elderly group compared with young group. In elderly, AOPP levels correlated with triglycerides, uric acid, total antioxidant capacity and fibrinogen. AOPP appear to be important components in the complex pathophysiology of oxidative stress and could be taken as a reliable marker to estimate the degree of oxidant-mediated protein damage in aging and to assessed the potential efficacy of the antioxidant and anti-aging therapeutic strategies.

Mitochondria and peroxisomes rolein oxidative stressassociated with agingElena Lupeanu The National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

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Aging is characterized among its particularities, by a gradual decline of biological systems' capacities to react to stress factors in order to preserve internal homeostasis. Previous research we undertook led us to advance a concept regarding the existence of some stress types. These aforementioned occur at cellular levels and it was possible to quantify the cell reaction and to modulate it through physical, chemical or biological factors. By use of an original method (patent of invention O.S.I.M Romania), we did define some particularities of the cell reactions to stress. The idea that mild stress has beneficial effects for organism, leads to cells' life span increase and delays the aging process is well known as the “hormesis” phenomenon. The hypothesis that we attempt to advance is based on considerable research we carried out with regard to procaine and Gerovital H3 mechanisms of actions. Hence, studies we conducted “in vitro” using cell cultures showed that procaine as an active compound as well as Gerovital, induced a state of stress at cellular levels, not depending on cell age. Our results evidenced that Gerovital H3 effect was rapidly exerted on cells after adding it into the cell culturing medium and the control samples and also the effect lasted for a longer time. According to most recent literature data, moderate and repeated stress induces activation of some substantial regenerating and repairing mechanisms at cellular levels. In this sense, the original Romanian procaine based products could be considered among the aforementioned therapeutic agents. Multiple beneficial and eutrophic effects might be explained by the fact that these mild stress inducing compounds repeatedly administered, stimulate regenerating mechanisms and at the same time may interfere in mechanisms specific of old age related degenerative disorders.

MILD STRESS AS A MODULATING FACTOR IN AGING

Mariana Rachita The National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

Disfunctiile tiroidiene sunt o categorie de patologie a carei incidenta si prevalenta varstnicului, ori chiar modificari considerate a apartine imbatranirii fiziologice. De aceea exista si numeroase recomandari de dozare periodica a TSH, la fiecare 5 ani, dupa varsta de 60 ani. Din toate aceste motive prezentam cazul unei femei in varsta de 60 ani, cunoscuta in antecedente cu doua accidente vasculare cerebrale, dislipidemie, care se prezinta la medicul de familie pentru un tablou tipic de depresie. Este indrumata catre medicul de specialitate, urmeaza tratament de specialitate dar simptomatologia se agraveaza. Avand in vedere ca simptomatologia era dominata de depresie asociata unei scaderi ponderale marcate, in lipsa raspunsului la antidepresive, este recomandata internarea. In urma investigatiilor clinice si paraclinice complexe efectuate se pune diagnosticul final de gusa uninodulara toxica. Sub tratament cu antiroidiene de sinteza, evolutia a fost favorabila cu remisia tututror simptomelor si reinsertia sociala a pacientei. Particularitatea cazului o constituie depresia ca manifestare de debut a unei hipertiroidii, foarte rar intalnita in clinica, stiut fiind ca tipic pentru o hipertiroidie sunt nervozitatea, nelinistea,

Manifestari atipice de debut, elementspecific al disfunctiilor tiroidiene la varstnicDr. Ileana Raducanu, dr. Raluca Pircalabu, dr. Bogdan Morosan, dr. Rodica Hnidei, dr. Catalina PenaThe National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

The thyroid disorders are a category of pathology with an increase incidence and prevalence with age. In addition the symptomatology at debut can cause high diagnosis problems because it can be paucisymptomatic, or mime other kind of geriatric pathology, or even can mime some change associate with physiologic aging. For these reason there is a recommendation to determine the TSH value, each 5 years for all people after 60 years old. We present the case of a 60 years old woman, known with two strokes and dislipidemia who came to general practitioner for a symptomatology typically for a depression. She is guided to the psychiatric specialist, she receives antidepressants treatment but the symptomatology aggravated. Because the symptomatology is dominated by depression associate with a decrease of body mass, without response of antidepressants, the general practitioner recommends the admission. After a complete investigation the final diagnosis is a uninodular toxic goiter. Under antithyroid drug, without antidepressants the evolution is favorable with remission of symptomatology and social reinsertion. The particularity of this case is the depression as debut symptom of a hypertiroidia, rarely quoted, especially when typical are the nervousness, agitation, irritability, logorrhea, hyperactivity and no depression.

Atypical symptoms of debut, element specific for thyroid disorders on elderlyDr. Ileana Raducanu, dr. Raluca Pircalabu, dr. Bogdan Morosan, dr. Rodica Hnidei, dr. Catalina PenaThe National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

The skin, the largest organ of the body, is the organ in which changes associated with aging are most visible. The skin is a target organ for various hormones, and sex steroids have a profound influence on the aging process. A decrease in sex steroids thus induces a reduction of those skin functions that are under hormonal control. Keratinocytes, Langerhans' cells, melanocytes, sebaceous glands, collagen content and the synthesis of hyaluronic acid, for example, are under hormonal influence. Potential consequences of age-associated decrease in plasma testosterone levels include long-term changes in diverse organ systems including changes of bone architecture, body composition, muscular strength, cognitive functions,and mood as well as negative effects on skin and hair. Estrogens clearly have a key role in skin aging homeostasis as evidenced by the accelerated decline in skin appearance seen in the perimenopausal years. Estrogens improve skin in many ways, they increase collagen content and skin thickness and improve skin moisture. Topical application of estrogens has a positive effect on skin aging parameters. As an alternative treatment, phytohormones may be administered, with the structural similarity to 17b-estradiol explaining their estrogen-like effects. However, isoflavonoids exhibit an inferior biological potency to synthetic estrogens. Currently, intensive research is conducted to develop new drugs called selective ER modulators (SERMs). These drugs exert mixed estrogenic and antiestrogenic effects depending on the tissue and cell type. One might expect in the future such a drug targeting specifically the skin without systemic side effects.

Age related changes in skin aging. Morpho-physiological differences related to gender.

Dr Anca Laura

Spitalul de Dermato-Venerologie Timisoara

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Lucrarea isi propune sa faca o trecere in revista a unei patologii aparent putin importante, de multe ori neglijata de medic si chiar de pacient, motiv pentru care diagnosticul este pus de obicei cu mare intarziere fata de debutul simptomelor. Sindromul picioarelor nelistite face parte din categoria tulburarilor motorii asociate somnului (parasomnii), iar incidenta ei este in crestere cu varsta. Simptomatologia este tipica si specifica bolii, poate fi variabila ca intensitate, de obicei progresiva, in formele grave atingand intensitatea de durere. Se poate asocia cu tulburari motorii voluntare, tulburari de somn (motiv pentru care este inclusa in categoria parasomniilor) si prin acestea pot afecta major calitatea vietii varstnicului. Masurile ce pot ameliora semnificativ simptomatologia sunt unele de ordin general, legate de stilul de viata, igiena somnului dar si unele de ordin farmacologice, existand medicamente dovedite a fi eficiente, in special din grupul celor indicate in Boala Parkinson.

Sindromul picioarelor nelinistite – tulburare motorie caracteristica pacientului varstnic

Dr. Ileana Raducanu, dr. Raluca Pircalabu, dr. Bogdan Morosan, dr. Rodica Hnidei, dr. Catalina PenaThe National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

This paper has as aim to review pathology apparently less important, many time ignored by physician but even by the patient too; this is the reason for the delay of diagnosis compared to the debut of symptoms. The restless legs syndrome is a motor behavior associated to sleep disorder (parasomias) and its incidence increase with age. The symptomatology is typical and specific to this disease, it can be variable as intensity, usually progressive, and in serious illness it has an ache level. It can be associated with voluntary movement disorder, sleep disorder (this is the reason to include the restless legs syndrome as parasomnias and especially by a decrease of quality of life. The measures that can improve the symptomatology are on the one hand general measure involving the life style, sleep hygiene and on the other hand pharmacological measures, some medicines have proved to be efficient, especially from the group of drugs indicated in Parkinson disease.

Restless legs syndrome – a motor disorder characteristics to the elderly patient

Dr. Ileana Raducanu, dr. Raluca Pircalabu, dr. Bogdan Morosan, dr. Rodica Hnidei, dr. Catalina PenaThe National Institute of Gerontology and Geriatrics “Ana Aslan” Bucharest

Aging is the natural consequence of society developing process. Postural stability is essential to the performance of most daily activities and is necessary to lead an independent lifestyle. At advanced ages the equilibrium diminishes as a result of the deterioration of the three systems involved: the visual system, the vestibular system, the proprioceptive system.The presbyastasis consists in the aging of these three systems As a result the risk of falls increases,the quality of life decreases. The importance of vestibular rehabilitation in order to improve the quality of life in the third age.

PRESBYASTASIS-THE SYNDROME OF INSTABILITY IN THE ELDERLYDr.G. Musat, Prof. Dr. D. Sarafoleanu

Aging is the natural consequence of society developing process. Postural stability is essential to the performance of most daily activities and is necessary to lead an independent lifestyle. At advanced ages the equilibrium diminishes as a result of the deterioration of the three systems involved: the visual system, the vestibular system, the proprioceptive system.The presbyastasis consists in the aging of these three systems As a result the risk of falls increases,the quality of life decreases. The importance of vestibular rehabilitation in order to improve the quality of life in the third age.

Presbivestibulia , sd de instabilitate alvarstniculuiDr.G. Musat, Prof. Dr. D. Sarafoleanu

Dr Anca Laura

Spitalul de Dermato-Venerologie Timisoara

PARTICULARITATI MORFOFIZIOLOGICE ALE TEGUMENTULUI I IMBATRANIT - DIFERENTIERI MORFOFIZIOLOGICE LEGATE DE SEX M/F

Pielea, cel mai mare organ al corpului ,este organul in care schimbarile asociate cu varsta sunt cele mai vizibile. Pielea este un organ tinta pentru diversi hormoni si steroizi sexuali au profunda influenta asupra procesului de imbatranire.O scadere a steroizilor sexuali induce astfel o reducere a functiilor pielii care sunt sub control hormonal. Keratinocitele, celulele Langerhans, melanocitele, glandele sebacee, continutul de colagen si sinteza acidului hialuronic, de exemplu, sunt tot sub inflenta hormonala. Posibile consecite ale scaderii cu varsta al nivelului testosteronului plasmatic, includ modificari la nivelul diferitelor organe cum ar fi: modificari la nivelul structurii osoase, a functiilor musculare, cognitive si a starii generale cat si efecte negative asupra parului si pielii.In mod clar estrogenii detin un rol important in procesul de imbatranire a pielii, evidentiata prin accelerarea deprecierii aspectului pielii in perioada de menopauza.Estrogenii imbunatatesc in mai multe feluri calitatea pielii, crescand continutul de colagen si troficitatea pielii.Aplicatiile topice de estrogen au efect pozitiv asupra pielii. Ca un tratament alternativ se pot administra phytohormoni, cu o structura similara cu cea a 17b-estradiol, demonstind efecte similiare cu cele ale estrogenilor.In prezent se fac studii pentru a gasi noi medicamente cu rol de modulatori selectivi (SERMS). Aceste medicamente exercita un efect mixt estrogenic antiestrogenic, dependent de tipul tesutului si al celulelor.Se asteapta ca pe viitor sa se descopere anumite tratamente cu beneficii asupra pielii si fara efecte adverse la nivel sistemic.





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It is known that first changes in immune reactivity occur in healthy old individuals, whereas secondary changes are those caused by various environmental factors and superposed diseases. The present study was undertaken to investigate whether or not changes occurred in the immune cellular parameters in healthy old subjects who were enrolled according to the Senieur protocol adopted by EURAGE. Based on these criteria, 50 persons aged between 30 and 85 years were included in 3 age groups: a control group aged between 30 and 55 years, a group of subjects aged between 56 and 65 years and a group of old individuals of ages between 66 and 85 years. Immunophenotypying based on antigen markers on cell surface of lymphocytes from peripheral blood, was undertaken for the following lymphocyte subsets : total T lymphocytes (CD3+), T helper /inducting (CD4+), T supressor/cytotoxic (CD8+), B lymphocytes (CD19+), NK (CD16+CD56+). Immunophenotypying was performed at a FACScan flow cytometer from Becton Dickinson. Analysis of average data obtained showed with increasing age a not significant decrease of T lymphocytes (CD3+) percentage, from 72,6% ± 3,7% to 70,5% ± 1,8%. Also a decrease from15,5% ±3% la 9,2% ± 1,1% was shown as regards the B lymphocytes (CD19+). For the NK subset (CD16+CD56+) we saw a significant increse from 9,8% ± 2,5% to 20% ± 1,6% was pointed out. A marked imbalance was reported for T lymphocyte subpopulations as with advancing age a T lymphocyte (CD4+) decrease occurred from 50,5% ± 4,2% to 43% ± 1,9%, while the percentage of T lymphocytes T (CD8+) was shown to significantly increase from 23,3% ± 3,5% to 37,8% ± 1,9%.The ratio Th/Ts lowered from 2,2 ± 0,6 to 1,2 ± 0,4 and reflected imbalance in these subpopulations .

CELLULAR IMMUNE STATUS IN OLD HEALTYSUBJECTS SELECTED ACCORDING TO THE SENIEUR PROTOCOL

Andrei Victoria, Adriana Dumitrescu, Speranta Babeanu, Catalina Pena, Simona Opris, Dana Dragan

Sepsis is a major challenge in medicine (can complicate infection

occurring at any site, most commonly the respiratory tract,

abdomen and blood stream). Sepsis is an infection-induced

syndrome defined as the presence of two or more of the following

features of systemic inflammation: fever or hypothermia,

leukocytosis or leukopenia, tachycardia, and tachypnea or a

supranormal minute ventilation. Sepsis and its sequelae constitute

a major cause of morbidity and mortality in intensive care units.

Severe sepsis is associated with mortality rates ranging from 30%

to 50%. Sepsis is characterized by a severe inflammatory response

syndrome (SIRS) evoked by an infection. Severe sepsis, defined as

sepsis associated with acute organ dysfunction, results from a

generalized inflammatory and procoagulant response to infection.

More than 90% of cases of sepsis are caused by bacteria Gram-

negative and Gram-positive occur with approximately equal

frequency. Fungi - in particular Candida species – are sometimes

responsible, but a wide variety of other organisms have

occasionally been implicated. Septic patients exhibit a high degree

Microbiologic considerations in sepsis in elderly

Alexandra Dana Maria Panait, M. Cojocaru, M. Negut

monocytes, macrophages, and neutrophils. The incidence continues to increase despite the use of specific antibiotics. Our enhanced understanding of the microbial cause of sepsis may be important in the choice of adjunctive therapies for elderly.

Compozitia ceaiului verde este complexa. Contine catechiune (10-18%), cafeina (3-4%) acid gama amino butiric (0,1%-0,2%) flavonoide (0,6-0,7%), polizaharide(0,6%), fluorine(aproximativ 190mg%) vitamina E(25-70%), theanine (0,6-2%). Actiunea terapeutica a ceaiului verde este datorata multiplelor inele fenolice. Dintre acestea rolul major il reprezinta flavonoidele (catechinele de tipul epicatechinele, galatul de epicatechinele , galatul de epigalocatechine, şi proantocianidele). Studiile experimentale au demonstrat ca flavonoidele din ceaiul verde sunt efectivi antioxidanţi împotriva radicalilor liberi de ROS, blocheaza producerea de oxigen reactiv derivat din NADPH-citocrom P450.Catechinele din ceaiul verde modifică metabolismul lipidic prin: reducerea absorbtiei trigliceridelor si colesterolului, cresc excretia de grasimi, inhiba peroxidarea lipidelor, inhiba oxidarea a LDL, intervine concurenţial cu HDL colesterol, şi în consecinţă se produce efectul antiaterosclerotic. Mai este raportat cresterea deficitului de apolipoproteina E dupa consumul de ceai verde. Galatul de epigalocatechina intervine in controlul apetitului (posibil prin interceptarea receptorilor leptinici care au rol in cresterea apetitului, dar si prin modificari hormonale) determinind scaderea in greutate.In testul de toleranta la glucoză catechinele din ceaiul verde descresc nivelul plasmatic al insulinei dar nu modifica nivelul plasmatic al glucozei.Prin inhibarea formarea tromboxanului si inhibarea agregarea plachetelor intervine in prevenirea placii aterosclerotice. Efectele benefice ale catechinelor din ceaiul verde se obţin atunci când epigalocatechinele au o rată de 0,01 la 2,5% din dietă, ceea ce se obtine prin consum de doze mari.Introducere Sudiile din ultimii ani sunt orientate tot mai mult spre gasirea unor remedii cit mai naturale pentru ameliorarea diferitelor afectiuni. Efectele secundare neglijabile ale ceaiului verde fac ca acesta sa constituie o alternativa de tratament. Aterosleroza la rindul ei a stimulat multiple cercetari, si actualmente inca prezinta multe necunoscute. Implicarea ceiului verde in mecanismele imunologice, unele ce par a declansa ateroscleroza, a incitat la o analiza minutioasa a compozitiei ceaiului verde. Catechinele constiuie principalele componente cu rol benefic. Dintre acestea cele mai importante sunt: EC (epicatechina) ECg (galatul de epicatechina)EGC (epigalocatechina), EGCG (galatul de epigalocatechina). Insa ceaiul verde contine si alti factori care sunt implicati in reducerea riscului aterogenetic ca vitamina E, etc. Reducerea chemotactismului neutrofilelor, blocarea genei expresiei TNF si a producerii de proteine prin inhibarea NF-KB determina reducerea raspunsului inflamator si ca urmare diminuarea proceselor aterosclerozei. Mecanismele prin care ceaiului verde este implicat in prevenirea aterosclerozeiCompoziţia ceaiului verde este diferita, în funcţie de climat, sezon, practicarea horiculturii, virsta frunzelor, inclusiv pozitia frunzelor pe ramuri). De remarcat ca este de importanta majora si zona de unde este recoltat. Componentul important al acestora il reprezinta multiplele inele fenolice (A este inelul fenolic a 6- carbon benzen ), inel care are atasat gruparea OH. Fenolii majori

PREVINE CEAIUL VERDE ATEROSCLEROZA?

Ciomaga Georgeta Spitalul “C.I. Parhon “ Iasi

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implicit reducerea infiltraţiei neutrofilice se produce dupa administrarea de galatul de epigalocatechina. . (3, 9 ) Catechinele actioneaza ca antioxidant si prin prevenirea oxidarii vitaminei E, component existent si in ceaiul verde. —(9, 3, 11, 12 ) Efectul se produce numai dupa consumul de lunga durata si de concentratii mari. (13, 14) Ceaiul verde actioneaza asupra metabolismului glucozei prin scaderea nivelului glicemiei serice, iar la testul de toleranta la glucoza determina reducerea nivelului insulinei plasmatice. Mecanismele care intervin nu sunt inca elucidate.(15, 16 )Consumul de 90mg/zi de galat de epigalocatechina determina o scadere in greutate de 4% pina la 21% ca urmare a actiunii asupra receptorilor leptinici (implicati in cresterea apetitului), reglarea unor sisteme hormonale. ConcluziiCeaiul verde constituie un preparat util ca medicatie alternativa. Multe din actiunile benefice au fost deja demonstrate. Dar, la ora actuala concluziile nu sunt unanime. Multi alti autori nu remarca toate aceste benficii. Mai mult, inca nu sunt studii demonstrate decit pe animale. Se sugereaza ca efectele ceaiului verde depind si de animalul asupra caruia s-a efectuat cercetarea, de tipul de frunze folosite. Efectele benefice s-au obtinut numai cind au fost folosite concentratii mari, de lunga durata, din frunze foarte tinere si numai din anumite zone. Un incovenient major este ca la virstnici, dar chiar si la tineriuneori sunt contraindicate cantitati mari de lichide, ori dozele recomandate zilnic sunt de 6-8 cani pe zi.

Bibliografie

1 Raederstorff, D. G., Schlachter, M. F., Elste, V. & Weber, P. (2003) Effect of EGCG on lipid absorption and plasma lipid levels in rats. J. Nutr. Biochem. 14:326-332.[Medline]2 Loest, H. B., Noh, S. K. & Koo, S. I. (2002) Green tea extract inhibits the lymphatic absorption of cholesterol and alpha-tocopherol in ovariectomized rats. J. Nutr. 132:1282-1288.[Abstract/Free Full Text]3 Yokozawa, T., Nakagawa, T. & Kitani, K. (2002) Antioxidative activity of green tea polyphenol in cholesterol-fed rats. J. Agric. Food Chem. 50:3549-35524 Miura, Y., Chiba, T., Tomita, I., Koizumi, H., Miura, S., Umegaki, K., Hara, Y., Ikeda, M. & Tomita, T. (2001) Tea catechins prevent the development of atherosclerosis in apoprotein E-deficient mice. J. Nutr. 131:27-32.[Abstract/Free Full Text] 5 Benzie IF, Szeto YT, Strain JJ, Tomlinson B. Consumption of green tea causes rapid increase in plasma antioxidant power in humans. Nutr Cancer. 1999;34(1):83-7. 3.6 Dulloo AG, Duret C, Rohrer D, Girardier L, Mensi N, Fathi M, Chantre P, Vandermander J. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. Am J Clin Nutr. 1999 Dec;70(6):1040-5.7 Lee, M. J., Maliakal, P., Chen, L., Meng, X., Bondoc, F. Y., Prabhu, S., Lambert, G., Mohr, S. & Yang, C. S. (2002) Pharmacokinetics of tea catechins after ingestion of green tea and (–)-epigallocatechin-3-gallate by humans: formation of different metabolites and individual variability. Cancer Epidemiol. Biomarkers Prev. 11:1025-1032.[Abstract/Free Full Text] 8 Ullmann, U., Haller, J., Decourt, J. P., Girault, N., Girault, J., Richard-Caudron, A. S., Pineau, B. & Weber, P. (2003) A single ascending dose study of epigallocatechin gallate in healthy volunteers. J. Int. Med. Res. 31:88-101.[Medline]9 Skrzydlewska, E., Ostrowska, J., Farbiszewski, R. & Michalak, K. (2002) Protective effect of green tea against lipid peroxidation in the rat liver, blood serum and the brain. Phytomedicine 9:232-238.[Medline]10 Negishi, H., Xu, J. W., Ikeda, K., Njelekela, M., Nara, Y. & Yamori, Y. (2004) Black and green tea polyphenols attenuate blood pressure increases in stroke-prone spontaneously hypertensive rats. J. Nutr. 134:38-42.[Abstract/Free Full Text] 11 Tijburg, L. B., Wiseman, S. A., Meijer, G. W. & Weststrate, J. A. (1997) Effects of green tea, black tea and dietary lipophilic antioxidants on LDL oxidizability and atherosclerosis in hypercholesterolaemic rabbits. Atherosclerosis 135:37-47.[Medline]12 Alessio, H. M., Hagerman, A. E., Romanello, M., Carando, S., Threlkeld, A. E., Rogers, M. S., Dimitrova, Y., Muhammed, S. & Wiley, R. L. (2003) Consumption of green tea protects rats from exercise-induced oxidative stress in kidney and liver. Nutr. Res. 22:1177-1188.13 K.E. Wangen, A.M. Duncan, X. Xu and M.S. Kurzer, Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women, Am J Clin Nutr 73 (2001), pp. 225–231. View Record in Scopus | Cited By in Scopus (95) 14 J.B. Howes, D. Sullivan, N. Lai, P. Nestel, S. Pomeroy and L. West et al., The effects of dietary supplementation with isoflavones from red clover on the lipoprotein profiles of postmenopausal women with mild to moderate hypercholesterolaemia, Atherosclerosis 152 (2000), pp. 143–147. SummaryPlus | Full Text + Links | PDF (78 K)15 Sabu, M. C., Smitha, K. & Kuttan, R. (2002) Anti-diabetic activity of green tea polyphenols and their role in reducing oxidative stress in experimental diabetes. J. Ethnopharmacol. 83:109-116.[Medline]16 Wu, L. Y., Juan, C. C., Ho, L. T., Hsu, Y. P. & Hwang, L. S. (2004) Effect of green tea supplementation on insulin sensitivity in Sprague-Dawley rats. J. Agric. Food Chem. 52:643-648.[Medline]

din ceaiul verde sunt flavonoidele (exemplu catechinele, epicatechinele, galatul de epicatechinele, galatul de epigalocatechine, şi proantocianidele.Este deja demonstrat ca aceste catechine care au efecte antiaterosclerotice prin proprietatile de antioxidant, radioprotectiv, antimutagenic, antitumoral, inhibarea enzimatica, antihipercolesterolemic, antihiperglicemic, antihipertensiv, reducerea grasimilor sanguine, antiulceros, antibacterian, antiviral,etc. Catechinele descresc absorbtia a trigliceridelor şi colesterolului,-(1, 2) favorizeaza creşterea excretiei de grăsimi.-(1)Prin consumul de ceai verde se produce scaderea nivelului plasmatic al colesteroului total , descresterea LDL colesterol, („bad” colesterol) de pina la 36% (3)-creşterea concurenţial al HDL colesterol, deficit de apolipoproteina E (4) Epigalatul de epigalocatechina reduce lipidele si la pacientii cu dieta bogata in grasimi prin modularea metabolismului lipidic.Galatul epigalocatechiune induce inhibarea de soybean lipoxygenase, inhiba TPA-inductoare de ADN-oxidativ base modificat în celulel HeLa , inhibă Cu2+-mediază oxidarea a LDL, reduce tert-butyl hydroperoxid-inductoare de peroxidarea lipidică şi blochează producerea de specii de oxigen reactiv derivate din NADPH-citocrom P450-mediator de oxidare a mediatorilor carcinogeni, a 2-amino-3methylimidazo[4,5-f]quinoline. (5)Antioxidantele în exces din ceaiul verde sunt eliminate de organism. Actiunea ceaiului verde asupra mecanismelor moleculare par a fi prin efecte pleiotropice. Este deja demonstrat ca dupa consumul de ceai verde se produce descresterea semnificativă a capacităţii antioxidante umane. (6, 7)—Efectul se realizeaza atit prin actiunea catechinelor dar si al vitaminelor (de exemplu vitamina C şi E) si al enzimelor (de exemplu superoxiddismutazei şi catalazei) care sunt continute in ceaiul verde. Prin cresterea activitatii superoxiddismutazei, si a expresiei catalazei din ser, se favorizeaza protectia celulara impotriva speciilor de oxigen reactiv. Actiunea este combinata cu descresterea concentratiei de oxid nitric. Malondialdehyde, marker al stressului oxidativ descreste dupa ce se consumă ceai verde. Aceasta sugereza ca aceste catechine pot avea actiune directa (antioxidanta) sau indirectă (prin descresterea activitatii sau expresiei acestora). 39,--40,--41,--50---- În vivo catechinele din ceaiul verde cresc capacitatea antioxidantă a plasmei—39—40—O alta actiune de interferare a proceselor inflamatorii aterosclerotice , si in deosebi al galatului de epigalocatechina este inhibarea chemotaxiei neutrofilelor, reducerea creatin fosfokinazei, activarea mitogenului extracelular (care este activator al proteinkinazei C si al STAT-1), mecanisme prin care se remodeleaza functia normala endoteliala. Prin actiunea antiplachetara se reduce riscul de tromboza. . 20-26---Catechinele determina inhibarea expresiei genelor IL-8 din celulele epiteliale respiratorii ca urmare a inhibarii IKK. –27--Testul experimental cu perfuzie cu 10mg/kg în bolus apoi cu perfuzie cu EGCG în doze de 10 mg/kg/oră determina reducerea zonei de necroza , reduce alterarea arhitecturii din edemul interstiţial.Perfuzia cu galatul de epigalocatechina dupa un infarct determina reducerea semnificativa a IL-6. Acesta este un marcher important al hipoxiei si ischemiei miocardice si titrul acestuia este direct corelat cu gradul de necroza.Reperfuzia după ischemie este caracterizată prin acumulare de neutrofile în ţesutul miocardic. Activitatea mieloperoxidazei, enzimă specific lizozomului granulocitelor, corelat cu numărul a neutrofilelor, este semnificativ crescută în ischemia cardiacă. Studii au demonstrate ca reducerea activităţii mieloperoxidazei si





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The green tea composition is complex. It contains catechins (10-18%), caffeine (3-4%), gamma aminobutyric acid (0,1-0,2%), f lavonoids (0,6-0,7%), polysaharides (0,6%), f luorins (approximatelly 190mg%), vitamin E (25-70%), theanine (0,6-2%). The therapeutic action of green tea is due to his multiple phenol rings. From all this, flavonoids (catechins like epicatechins, epigallocatechins, epigallocatechin gallate and proanthocyanides).Experimental studies have proved flavonoids from green tea are antioxidants against ROS free radicals and inhibit reactive oxygen production, derived from NADPH-cytocrom P450. Catechins from green tea alter the lipidic metabolism by reducing the triglycerides and cholesterol absorption, increase fat excretion, inhibit fat peroxidation and LDL oxidation, compete with HDL cholesterol and, in the end, they generate antiatherosclerotic effects.It has been reported an increased apolipoprotein E deficit after green tea ingestion.Epigallocatechins gallate interferes with appetite control (possibily, by interception of leptinic receptors and by changing the hormonal status), causing weight loss. In oral glucose tolerance test, the catechins from green tea decrease insulin plasma levels, but the blood glucose levels are not changed.By inhibiting the tromboxan A2 synthesis and platelet aggregation, it prevents the atherosclerosis plaque formation.The good effects of green tea catechins can be obtained when epigallocatechins represents 0,01-2,5% from diet, and this needs to ingest high doses.

INTRODUCTION

The purpose of the studies from the last years was to find some natural treatments. It's minor side effects make green tea an alternative therapie. Atherosclerosis was a subject for many studies and it still has today many unknown elements. The role of green tea in immunological mechanism, some of them which seems to be involved in realising atherosclerosis, had forced at a minute analysis of green tea composition.Cathechins are the main parts with positive effects. From all of this, the more important are: EC (apicatechin, ECg (epicatechin gallate), EGC (epigallocatechin), EGCG (epigallocatechin gallate). But green tea is has other elements which are involved in decreasing of atherogenetic risk like vitamin E, etc.The decresing of neutrophil chemotaxis, the blocking of the TNF gene expression and protein synthesis by inbiting NF-kB, is followed by the decreasing of inflammatory reaction, and, in the end, by the decreasing of atherosclerosis process.

The mechanism by which the green tea is involved in atherosclerosis prevention

The composition of green tea differs by climate, season, horticultury, leaves age , even by the leaf place on the branch. The soil zone has a major importance, too. Their important elements are the multiple phenols rings ( A is phenol ring of the 6th carbon of benzene nucleus) which have a OH group attached. The major

phenols from green tea are flavonoids (for exemple, catechins, epicatechins, epicatechin gallate, epigallocatechins gallate and proanthocyanides.It is known already that this catechins have antiatherosclerotic effects by their antioxidant, radioprotection, antimutagenic, antitumoral, antihypercholesterolic , antihyperglicemic, antihypertension, antiulcerous, antibacterial, antiviral, inbiting the enzyme activity, decreasing the blood lipids, etc.Catechins decrease the triglycerides and cholesterol (1,2) absorption and increase fat excretion (1).There is a decreasing of total cholesterol level and a decreasing of LDL cholesterol (“bad” cholesterol) up to 36% (3), an concurential increasing of HDL cholesterol and apolipoprotein E.The epigallocatechin gallate decreases the lipids at patients with rich fat diet by modulating lipid metabolism.The epigallocatechin gallate induces inhibition of soybean lipoxygenase, ………………………………. Cu 2+, mediates LDL oxidation, reduces …………………………. ,blocks reactive oxygen species synthesis NADPH cytocrom P450 dependent-…………………………………………………………………………………., Any excess antioxidants wil be eliminated from the body.The green tea effect on molecular mechanism seems to be pleiotropic. It is known already that after green tea ingestion, there is an significant decrease of human antioxidant capacity (6,7). This effect appears due to catechins action, but olso due to vitamins (for exemple: superoxiddismutase and cathalase) conteined by green tea.By increseasing of superoxiddismutase activity and cathalase expression from plasma, it is favorised cell protection against rective oxygen species. This process is associated with the decreasing of nitric oxyd. Malondyaldehide, an oxidativ stress marker, decreases after green tea ingestion. This means that this catechins may have a direct action (antioxidative) or an indirect one (by decreasing of their expression or activity) (39,40,41,50).In vivo, the green tea catechins raise plasma antioxidant capacity (39,40).Another action is to interfere with atherosclerotic inflammatory processes. Specially, epigallocatechin gallate inhibits neutrophil chemotaxis, decreasing creatine phosphokinase and extracellular mitogen (which is an proteinkinase C and STAT-1 activator), mechanisms which remodelates the normal endothelial function. By antiplatelet function, the thromboses risk is decreased (20, 26).Catechins inhibate IL-8 gene expression from respiratory epithelial cells as a result of IKK inhibition.The experimental venous bolus administration of 10mg/kg EGCG , followed by 10mg/kg/hour, produces the decreasing of necrotic zone and the destroyed structure from interstitial edema.Venous administration of epigallocatechin gallate after a myocardial infarction is followed by a significantly IL-6 decreasing . This is a very important marker of myocardial hypoxia and ischemia and it's titer is directly related to the necrotic degree. Reperfusion after ischemia is characterized by neutrophilic accumulation in myocardial tissue. Myeloperoxidase activity, an specific enzyme from lysosoms from granulocytes, associated with the neutrophilic number, is significantly raised in myocardial ischemia.Some studies has proved that decreased myeloperoxidase activity and neutrophilic infiltration appear after venous administration of epigallocatechin gallate.(3,9) Catechins heve an antioxidant activity by preventing the vitamin E oxidation, a component of green tea. (9, 3, 11, 12)The effect appears after a long time ingestion of high doses(13, 14).The green tea actions on glucose metabolism by decreasing of plasmatic glucose level, and the oral glucose tolerance test

MAY GREEN TEA PREVENT ATHEROSCLEROSIS?

Ciomaga Georgeta Spitalul “C.I. Parhon “ Iasi





39

produces the decreasig of plasmatic insulin level. The mechanisms involved aren't clear. (15,16)The ingestion of 90mg/day of epigallocatechin gallate produces the low grow weght of 4% up to 21% as a result of action on leptinic receptors (involved in high appetite), adjusting the hormonal systems. Conclusions:The green tea it's an useful treatment as an alternative medication. Many of it's actions have already been proven. But, at this time, the conclusions aren't unanims. Many other authors do not remark this good effects., even more, some studies were made only on animals. It has been suggested that grenn tea effects depend by the animal studied and leaves type used. The good effects were obtained only when it was used high doses for a long time, very young leaves and only from certain zones. A very important desavantadge is using it at old people, and some times at young people, because they must drink 6-8 cups per day.

Bibliografie

Raederstorff, D. G., Schlachter, M. F., Elste, V. & Weber, P. (2003) Effect of EGCG on lipid absorption and plasma lipid levels in rats. J. Nutr. Biochem. 14:326-332.[Medline]2 Loest, H. B., Noh, S. K. & Koo, S. I. (2002) Green tea extract inhibits the lymphatic absorption of cholesterol and alpha-tocopherol in ovariectomized rats. J. Nutr. 132:1282-1288.[Abstract/Free Full Text]3 Yokozawa, T., Nakagawa, T. & Kitani, K. (2002) Antioxidative activity of green tea polyphenol in cholesterol-fed rats. J. Agric. Food Chem. 50:3549-35524 Miura, Y., Chiba, T., Tomita, I., Koizumi, H., Miura, S., Umegaki, K., Hara, Y., Ikeda, M. & Tomita, T. (2001) Tea catechins prevent the development of atherosclerosis in apoprotein E-deficient mice. J. Nutr. 131:27-32.[Abstract/Free Full Text] 5 Benzie IF, Szeto YT, Strain JJ, Tomlinson B. Consumption of green tea causes rapid increase in plasma antioxidant power in humans. Nutr Cancer. 1999;34(1):83-7. 3.6 Dulloo AG, Duret C, Rohrer D, Girardier L, Mensi N, Fathi M, Chantre P, Vandermander J. Efficacy of a green tea extract rich in catechin polyphenols and caffeine in increasing 24-h energy expenditure and fat oxidation in humans. Am J Clin Nutr. 1999 Dec;70(6):1040-5.7 Lee, M. J., Maliakal, P., Chen, L., Meng, X., Bondoc, F.Y ., Prabhu, S., Lambert, G., Mohr, S. & Yang, C. S. (2002) Pharmacokinetics of tea catechins after ingestion of green tea and (–)-epigallocatechin-3-gallate by humans: formation of different metabolites and individual variability. Cancer Epidemiol. Biomarkers Prev. 11:1025-1032.[Abstract/Free Full Text] 8 Ullmann, U., Haller, J., Decourt, J. P., Girault, N., Girault, J., Richard-Caudron, A. S., Pineau, B. & Weber, P. (2003) A single ascending dose study of epigallocatechin gallate in healthy volunteers. J. Int. Med. Res. 31:88-101.[Medline]9 Skrzydlewska, E., Ostrowska, J., Farbiszewski, R. & Michalak, K. (2002) Protective effect of green tea against lipid peroxidation in the rat liver, blood serum and the brain. Phytomedicine 9:232-238.[Medline]10 Negishi, H., Xu, J. W., Ikeda, K., Njelekela, M., Nara, Y. & Yamori, Y. (2004) Black and green tea polyphenols attenuate blood pressure increases in stroke-prone spontaneously hypertensive rats. J. Nutr. 134:38-42.[Abstract/Free Full Text] 11 Tijburg, L. B., Wiseman, S. A., Meijer, G. W. & Weststrate, J. A. (1997) Effects of green tea, black tea and dietary lipophilic antioxidants on LDL oxidizability and atherosclerosis in hypercholesterolaemic rabbits. Atherosclerosis 135:37-47.[Medline]12 Alessio, H. M., Hagerman, A. E., Romanello, M., Carando, S., Threlkeld, A. E., Rogers, M. S., Dimitrova, Y., Muhammed, S. & Wiley, R. L. (2003) Consumption of green tea protects rats from exercise-induced oxidative stress in kidney and liver. Nutr. Res. 22:1177-1188.13 K.E. Wangen, A.M. Duncan, X. Xu and M.S. Kurzer, Soy isoflavones improve plasma lipids in normocholesterolemic and mildly hypercholesterolemic postmenopausal women, Am J Clin Nutr 73 (2001), pp. 225–231. View Record in Scopus | Cited By in Scopus (95) 14 J.B. Howes, D. Sullivan, N. Lai, P. Nestel, S. Pomeroy and L. West et al., The effects of dietary supplementation with isoflavones from red clover on the lipoprotein profiles of postmenopausal women with mild to moderate hypercholesterolaemia, Atherosclerosis 152 (2000), pp. 143–147. SummaryPlus | Full Text + Links | PDF (78 K)15 Sabu, M. C., Smitha, K. & Kuttan, R. (2002) Anti-diabetic activity of green tea polyphenols and their role in reducing oxidative stress in experimental diabetes. J. Ethnopharmacol. 83:109-116.[Medline]16 Wu, L. Y., Juan, C. C., Ho, L. T., Hsu, Y. P. & Hwang, L. S. (2004) Effect of green tea supplementation on insulin sensitivity in Sprague-Dawley rats. J. Agric. Food Chem. 52:643-648.[Medline]

IMPLICAREA CEAIULUI VERDE IN BOLILE CARDIOVASCULARE Nanescu Sonia Elena , Ciomaga Georgeta , Aghiorgiesei Madalina

Catechinele din ceaiul verde au rol antiinflamator si antioxidativ. In miocardita se produce un raspuns important prin infiltrarea miocardului cu celule multinucleare gigante si necroza extensiva. Catechinele reduc substantial acest rapuns si reducprocesele de fibroza. Suprimarea infiltrarii celulare si a fibrozei se produce prin alterarea expresiei Th1/Th2. Productia de TNF alfa si de IL-2 este redusa iar productia de IL-4 si de IL-10 este de asemeni modificata. Prin inhibarea genei expresiei receptorului PDGF se blocheaza activarea transcriptiei proteinei -1 si a Nf-kB care sunt cunoscute cu rol de inducere a fibrozei. Se produce de asemeni o reducere a raspunsului imun prin reducerea nivelului de ICAM-1, a NF-kB si a citochinele proinflamatorii mARN a TNF alfa. Are rol in reducerea metabolitilor speciilor de oxigen reactiv –anioni superoxizi, radicali hidroxilici care determina stressul oxidativ si rapunsul proteinelor ADN si al lipidelor. Prin aceasta se inhiba semnalul de transcriptie redox. EGCG contribuie direct in ROS prin generare de peroxid de hidrogen. Are rol in a inhiba migrarea de celule musculare vasculare smooth, inhiba hiperplazia de neointima prin interactiunea cu matricea metaloproteinazei. Monocitele au rol important in initierea si dezvoltarea aterosclerozei. EGCG induce apoptoza monocitelor prin activarea caspazelor 8 si 9. Catechinele inhiba agregarea trombocitelor indusa de ADP, colagen epinefrina, sau de calcium ionophore, reduce productia de factor activator al trombocitelor, inhibarea acetil coenzima A, inhibarea trombinei-inductoare de tirozin fosforilarea a proteinelor trombocitare.

THE INVOLVEMENT OF GREEN TEA IN CARDIOVASCULAR DISEASES Nanescu Sonia Elena , Ciomaga Georgeta , Aghiorgiesei Madalina

Catechins from green tea have an anti-inflammatory and anti-oxidative role. In myocarditis there is an important response characterized by infiltrating of myocardium with giant multinuclear cells and extensive necrosis. Catechins reduce substantially this response and fibrosis process. The suppression of cell infiltration and fibrosis is caused by altering the Th1/Th2 expression.TNF alpha and IL-2 synthesis is reduced, and IL-4 and IL-10 synthesis is modified, too.By inhibiting the PDGF receptor-gene, the transcription activation of protein-1 and NF-kB is stopped. Protein-1 and NF-kB has the role to induce fibrosis. Thereis, olso, a reducing of autoimmune response by reducing ICAM-1, NF-kB and TNF alpha mARN proinflammatory cytokines. It has a role in reducing the reactive oxygen species-superoxid anion, hydroxyl radical whichproduces oxidative stress and a response of AND protein and lipids. Thus, the redox transcription sgnal is stopped.EGCG contribute directly at ROS by producing hydrogen peroxide. It has a role to inhibit the vessel smooth muscle cell migration, inhibit neointima hyperplasia through interaction with metalloproteinase matrix.Monocytes have an important role in initiating and developing atherosclerosis. EGCG induce monocytes apoptosis activating the 8 and 9 caspases.Catechins inhibit the platelet aggregation induced by ADP, collagen epinephrine or calcium ionophore, reduce platelet activating factor, inhibit the trombone which induces tyrosine phosphorilation of platelet proteins.

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INCIDENTA BOLILOR CARDIVASCULARE LA FEMEILE DE VIRSTA A TREIA CARE AU ASOCIAT SINDROM DISMETABOLIC DE CLIMAX Ciomaga Georgeta , Nanescu Sonia Elena , Aghiorgiesei Madalina

Sindromul metabolic de climax determina perturbari metabolice cu predispozitie puternică spre ateroscleroza determinate de lipsa protectiei estrogenice . Cuprinde de fapt rezistenta la insulina,obezitatea centrala, hiperinsulinism, dislipidemie, hipertensiunea arteriala, hiperuricemie, guta si ficatul gras. Dupa menopauza se produce un dezechilibru privind lipidele plasmatice: creste concentraţia colesterolului total, a LDL, se produce afectarea functionalitatii receptorului LDL. Se asociaza cu productia crescuta de LDL3 care este mai aterogenetic. La menopauză se produc dezordini ale coagulării, ale sistemului fibrinolitic, cu creşterea markerilor protrombotici: concentraţia crescută de fibrinogen, ale factorului VIIc, al plasminogen activator inhibitor 1 (PAI-1) şi complexului trombin-antitrombin III. Asocierea fumatului, sedentarismului, dieta bogata in grasimi animale fac ca riscul bolilor cardiovasculare sa fie mult crescut. Riscul aterosclerozei la femei creste exponential cu virsta. La 80 ani incidenta bolilor cardiovasculare este aceeasi la femei ca si la barbati. Studiul s-a efectuat pe un lot de 786 pacienti de virsta a treia internati in clinica, pe o perioada de un an. Din acestia 443 sunt femei. Sindromul dismetabolic este prezent la 74 paciente. Dintre acestea se remarca prezenta cardiopatiei ischemice silentioase la 38 , tulburari de ritm (fibrilatie, flutter atrial) la 30.De remarcat ca 36 paciente au fost obeze, iar dintre pacientele cu diabet zaharat 2 au necesitat tratament cu insulina si 8 cu antidiabetice orale.

ITHE INCIDENCE OF CARDIOVASCULAR DISEASES AT THIRD AGE FEMALES WHO ASSOCIATED CLIMAX METABOLIC SYNDROME Ciomaga Georgeta , Nanescu Sonia Elena , Aghiorgiesei Madalina

Climax metabolic syndrome generates metabolic disorders with a strong predisposal for atherosclerosis, caused by the absence of estrogenic protection. In fact, it contains insulin resistance, central obesity, hyperinsulinism, arterial hypertension, hyperuricemi, gout and fatty liver. After menopauses, there is a plasmatic lipids disorder: cholesterol and LDL cholesterol levels increase and the LDL receptor function is deteriorated.. It is associated with an increased LDL3 synthesis, which is more atherogenic. At menopauses, there is disorders of coagulation system, fibrinolitic system and an increased protrombinic markers: raised levels of fibrinogen, VIIc factor, plasminogen activator inhibitor-1 (PAI-1) and trombin-antitrombin III complex.The association with smoking, sedentary lifestyle, animal fat diet contributes at a higher risk for cardiovascular diseases. The risk of atherosclerosis at females is exponential raised by age.At 80 years of age, the cardiovascular diseases at males and females is equal.The study was made on a trial of 786 third age patients, over one year period. From this patients, 443 was females. Metabolic syndrome was present at 74 females. From this, 38 had silent ischemic cardiopathy and 30 had arythmia (atrial fibrillation and flutter). We noticed that 36 females had obesity, 2 needed insulin tratement and 8 needed oral antidiabetic treatement.

Effects of stress on the immune system Manole Cojocaru

Stress is an adaptative response that is not unusual or unique to only certain individuals. Stress may suppress macrophage activity. Cytokines released by monocytes/macrophages and lymphocytes, upon antigenic stimulation, are able to cross the blood-brain-barrier, thus modulating nervous functions. In measuring the immune response, there are two basic ways, quatitatively measuring levels of cells, or second by using a functional measurement. The level of T-cells and responses to mitogens was lower. Stress caused a decreased production of IFN- and increased production of IL-10. Stress can better suppress IgG production.

Efectele stresului asupra sistemului imun Manole Cojocaru

Stresul este răspunsul adaptativ particular fiecărui individ. Stresul reprezintă reacţia organismului la stimulii care perturbă homeostazia organismului. Stresul suprimă activitatea macrofagului. Citokinele eliberate de monocite/macrofage sub influenţa stimului antigenic pot să traverseze bariera hematoencefalică şi să moduleze funcţiile SNC. Pentru evaluarea răspunsului imun se folosesc două metode: cantitative (numărul fiecărui tip de celule ) şi calitative (funcţionale). În condiţii de stres, numărul celulelor T şi răspunsurile la mitogene sunt scăzute. Stresul determină scăderea producerii de IFN- şi creşterea producerii de IL-10. Stresul suprimă îndeosebi producerea de IgG.





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Tratamentul laser CO2 in patologia orofaringiana


In perioada 1998 – 2007 au fost tratati prin chirurgie laser CO2 si urmariti in evolutie 130 de pacienti cu patologie orofaringiana, astfel: 50 de cazuri sforait si apnee in somn, 30 de cazuri amigdalita cronica criptica cazeoasa si 50 de cazuri formatiuni tumorale papilomatoase ale luetei si pilierilor amigdalieni.

Sforaitul este definit ca o respiratie zgomotoasa in timpul somnului aparand atunci cand fluxul de aer inspirat prin nas sau gura este perturbat din diverse cauze ce produc ingustarea cailor aeriene superioara la nivelul nasului si gatului. Ca urmare, tesuturile cailor aeriene vibreaza si se lovesc de partea posterioara a gatului, determinand aparitia unui sunet care poate fi moale, catifelat, inalt, aspru sau ragusit. Este posibil ca persoanele care sforaie sa nu fie constiente de acest lucru. Uneori partenerul/partenera observa ca persoana cu care dorm sforaie sau doarme cu gura deschisa. Daca sforaitul devine deranjant pentru persoana care sforaie sau pentru partenerul ei, poate apare oboseala diurna. In trecut, sforaitul era considerat doar o simpla neplacere pentru partenerul de viata. Recent s-a demonstrat ca persoanele care sforaie pot suferi de sindromul de rezistenta al cailor aeriene superioare (boala in care fluxul de aer inspirat intampina un grad de rezistenta la trecerea prin caile aeriene superioare) si apnee de somn obstructiva, o afectiune serioasa a somnului, in cadrul careia persoana poate inceta sa respire (apnee) in timpul somnului, datorita unui grad de obstructie la nivelul cailor aeriene.Apneea in somn poate sa se produca la pacienti intre 20 si 30 de episoade pe ora. Sforaitul si apneea in somn pot fi sau nu asociate. Sforaitul este o afectiune comuna, aproximativ 25-50% dintre barbati si 25-30% dintre femei sforaie frecvent. Apneea in somn este frecventa la 4% din barbatii de varsta medie si 2% din femeile de aceeasi varsta.Urmarile sforaitului si apneei in somn sunt neplacute pentru pacient: celafee matinala, oboseala pe tot parcursul zilei, cresterea presiunii dioxidului de carbon in sange, avand drept urmare cresterea tensiunii arteriale, aritmie cardiaca, infarct miocardic, accidente vasculare. Pacientii cu sforait zgomotos (80-82 db nivel al sunetului emis) afecteaza si somnul partenerului de viata.

Factorii de risc pentru sforait sunt urmatorii: factori genetici (marimea si forma uvulei, palatului moale, amigdalelor palatine, epiglotei determinate de ereditate), istoric familial de sforaitori, obezitatea, sedentarismul, consumul crescut de alcool, tutun si sedative, istoric de infectii respiratorii frecvente sau alergii, traumatisme in zona nasului, fetei sau gatului.

Materia si metodaAnamneza (cu depistarea factorilor de risc), examenul O.R.L. (clasic , urmat de f ibroscopie rinofaringolaringiana), polisomnografia la cei cu apnee in somn si probele paraclinice au precedat interventiile chirurgicale.Din cele 50 de cazuri de sforait si apnee in somn, 20 prezentau si afectiuni obstructive asociate: deviatie de sept nazal si rinita cronica. Grupere de varsta: intre 40 si 60 de ani au constituit 80% din pacienti, restul fiind tineri intre 30 si 40 de ani.Uvulopalatoplastia cu laser CO2 a fost efectuata in cabinetul medical fiind precedata de anestezie locala (spray cu Lidocaina in

zona palatului moale, uvula si amigdale, fiind urmata de infiltrarea cu Xilina 1% in aceeasi zona). S-au practicat 2 incizii verticale de o parte si de alta a luetei sectionandu-se lueta pana la 1/4 - 1/5 din lungimea ei. Nu am practicat rezectia totala a luetei si nici partial de palat moale datorita riscului de regurgitare nazala postoperatorie a alimentelor. Din cele 50 de cazuri operate, la 30 s-a practicat o singura interventie iar la 20 s-au efectuat 2 timpi chirurgicali (in al doilea completandu-se micsorarea luetei prin punctionarea sa cu laser). Interventiile s-au efectuat prin sectionarea cu alserul CO2 cu 12-15W in flux continuu. Evolutia a fost favorabila la 90% din ceice aveau apnee in somn prin scurtarea luetei si disparitia senzatiei de corp strain faringian in clinostatism. Ameliorarea sforaitului a avut loc la 60% din pacientii operati laser (din care 50% au suferit si o vaporizare laser a cornetelor nazale inferioare intr-o alta etapa ce a condus la ameliorarea respiratiei nazale). 10% din cazuri au suferit ulterior interventie chirurgicala clasica pentru repozitie septala si amigdalectomie.Efectele secundare postoperatorii au constat in durere severa la nivelul inciziei la 80% din pacienti si medie la 20% din pacienti (desi pacientii au primit antialgice general si local, au evitat alimentele rugoase si fierbinti), 2% din cazuri au avut edem pasager in zona valului palatin. Nu s-au observat sangerari postoperatorii. Din 50 de cazuri, 20 de pacienti au pierdut in greutate si au incercat sa isi schimbe obiceiurile alimentare si de viata.

Aspectul orofaringelui inainte si dupa operatia laser.

In decursul ultimilor 10 ani am selectat 30 de cazuri de amigdalita cronica critica (prin anamneza, prin probe paraclinice – fara focar de infectie streptococica cronica), prin examen O.R.L. local (amigdalite cronice criptice fara hipertrofie marcata amigdaliana, la acestia practicandu-se amigdalectomia clasica). Am efectuat criptoliza amigdaliana la pacienti cu amigdalita cronica criptica avand infectii amigdaliene repetate, eliminari de cazeum din cripte si halitoza marcata. Interventia laser a fost precedata de anestezie locala cu Xilina 1% si s-a practicat cu ajutorul dispozitivului Swiftlase, 10-15W, 3 sedinte la interval de 2 luni, ce au condus la reducerea volumului amigdalian, disparitia criptelor, a halenei fetide la 80% din cazuri. Restul de 20% au ajuns la amigdalectomie clasica. Formatiunile tumorale benigne (papiloame de lueta, val palatin, pilieri amigdalieni) – totalizand 50 de cazuri au fost vaporizare cu laser CO2 (9-10W in flux continuu) avand o evolutie favorabila la 98% din cazuri dupa prima sedinta iar restul de 2% au primit a doua sedinta laser la o luna interval, evolutie favorabila fara recidiva.

Bibliografie:· R. Calarasu, T. Antaman, V. Zainea – Manual de patologie ORL si chirurgie cervicofaciala – 2000· J.A.S. Carruth, G.T. Simpson - Lasers in Otolaryngology· http://www.surgeryencyclopedia.com - Encyclopedia of Surgery: A Guide for Patients and Caregivers· Laser-assisted surgery for snoring and obstructive sleep apnoeaY V Kamami

·Imagini pre si postoperator la pacient cu LAUP

favorable

mediocre

·PostLAUP results





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UPSHOP

Aspectul orofaringelui inainte si dupa operatia laser.

Laser CO2 surgical treatment in

oropharyngeal pathology


During 10 years (1998-2007) we treated by CO2 laser surgery and followed up a number of 130 patients with orofaringean pathology: 50 patients with snoring and sleep apnea, 30 patients having cronical criptical cazeoustonsilitis and 50 patients with papilamathosis of the uvula and palatal veil.Snoring is defined as noisy or rough breathing during sleep, caused by vibration of loose tissue in the upper airway, Surgical treatments for snoring include several different techniques for removing tissue from the back of the patient's throat, reshaping the nasal passages or jaw, or preventing the tongue from blocking the airway during sleep.The connection between heavy snoring, breathing disorders, and other health problems is a relatively recent discovery. Obstructive sleep apnea (OSA) is a breathing disorder that was first identified in 1965. OSA is marked by brief stoppages in breathing during sleep resulting from partial blockages of the airway. A person with OSA may stop breathing temporarily as often as 20-30 times per hour. He or she usually snores or makes chocking and gasping sounds between these episodes. The person is not refreshed by nighttime sleep and may suffer from morning headaches as well as daytime sleepiness. He or she may be misdiagnosed as suffering from clinical depression when the real problem is physical tiredness. In addition, the high levels of carbon dioxide that build up in the blood when a person is not breathing normally may eventually lead to high blood pressure, irregular heartbeat, heart attacks, and stroke. In children, heavy snoring appears to be a major risk factor for attention-deficit/hyperactivity disorder.Although people with OSA snore, not everyone who snores has OSA. It is thought that OSA affects about 4% of middle-aged males and 2% of middle-aged females. Most adults who snore have what is called primary snoring, which means that the loud sounds produced in the upper airway during sleep are not interrupted by episodes of breathing cessation. Other terms for primary snoring are simple snoring, benign snoring, rhythmical snoring, continuous snoring, and socially unacceptable snoring (SUS). Although primary snoring is not associated with severe disorders to the same extent as OSA, it has been shown to have negative consequences for health.People who snore heavily often keep other family members from getting a good night sleep. Some people however snore around 80-82 dB, affecting the room mate's sleep. Risk factors for snoring Genetic factors. The size and shape of the uvula, soft palate, tonsils, and other parts of the airway are largely determined by heredity.Family of heavy snoringAn unusually long soft palate and uvula. These structures narrow the airway between the nose and the throat. They act like noisy flutter valves when the person breathes in and out during sleep.Too much tissue in the throat. Large tonsils and adenoids can cause anoring, which is one reason why tonsillectomies are sometimes recommended to treat heavy snoring in children.Nasal congestion. When a person's nose is stuffy, their attempts to breathe create a partial vacuum in the throat that pulls the softer tissues of the throat together. This suction can also produce a snoring noise. Nasal congestion helps to explain why some people snore only when they have a cold or during pollen season. Anatomical deformations of the nose. People who have had their noses or cheekbones fractured or who have a deviated septum are more likely to snore, because their nasal passages develop a twisted or crooked shape and vibrate as air passes through them. Sleeping position. People are more likely to

snore when they are lying on the back because the force of gravity draws the tongue and soft tissues in the throat backward and downward, blocking the airway. Obesity. Obesity adds to the weight of the tissues in the neck, which can cause partial blockage of the airway during sleep. Use of alcohol, sleeping medications, or tranquilizers. These substances relax the throat muscles, which may become soft or limp enough to partially close the airway.

Methods and material: The history of the patient (and knowing the risk factors) the ENT examination (classical, followed by rhinofaringolaringeal fibroscopy), polisomnography and blood tests preceded the surgical procedures. From the 50 patients with snoring and sleep apnea 20 had also obstructive pathology (septum deviation and chronic rhinitis). 80% of the patients were between 40 and 60 years old, the rest of them being 30 to 40 years old.The laser CO2 uvulopalatoplasthy was proceeded in the ENT office under local anesthesia. The laser procedure meant two vertical incisions on either side of the uvula with a third incision removing up to 4/5 of the uvula. We didn't totally removed the uvula or partially the soft palate because of the postoperative risk of nasal regurgitation of food. From the 50 cases, 30 patients suffered only one surgical procedure and 20 of them suffered two surgical procedures (the second, after 1 month from the first, another shrinking of the uvula being needed, by puncturing it with the laser beam). The laser incisions were made with 12-15W laser beam power in a continuous pulse. The postoperatory results were 90% good for those who had a long uvula, because they lost the feeling of a foreign object in the pharynx. Snoring has decreased in over 60% of cases in which some of them had their inferior turbinated vaporized (50%). 10% of the patients had to suffer a classical surgery procedure like septal reposition or tonsilectomy to enlarge their upper airway. The side effects were severe pain and swelling of the palatal veil without bleeding (although the patients got medication for throat discomfort – analgesics).20 of the 50 patients tried to loose weight and change their lifestyle.

During the last 10 years we encountered 30 patients with chronic criptical tonsillitis by a local ENT exam and blood tests with a history of halitosis. We treated patients by using the CO2 laser beam with a Swiftlase handpiece 10-15W power doing it in three sessions every 2 months. The results consisted in reducing the tonsils, the disappearance of the cripts and halitosis in 80% of the cases. The rest of 20% suffered classical tonsillectomy.The papilomas of the uvula veil and tonsilar pillars (50 cases) vaporized by CO2 laser (9-10W continuous pulse) had a good result in 98% of cases, without local relapse, for the rest a second laser treatment being needed.

·Imagini pre si postoperator la pacient cu LAUP

favorable

mediocre

·PostLAUP results





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IMPROVING ESTHETIC WITH IMPLANTSUPPORTED MANDIBULAR OVERDENTURE

Cristache Gheorghe, MD, E.N.T. Specialist, Cristache Corina-Marilena, DMD, PhD, Ionescu Camelia, Diaconu Daniela

The purpose of the investigation is to compare in a prospective study the esthetic apparence, satisfaction level and masticatory capacity of mandibular edentulous individuals, applying questionnaires adapted from the indexes oral health-related quality of life (OHIP) and its short form OHIP-EDENT during the phases of rehabilitation treatment with a two-implants supported overdenture and the use of Straumann Implant System for elderly patients.Material and Methods: 69 (age 42-84)patients fully mandibular edentulous with severe alveolar ridge atrophy and instability of the existing lower denture were enrolled in the study.Each patient received two screw-type implants in the interforaminal region of the mandible. After 6 weeks healing period a new denture was made and the patients randomly assigned to one of the following equal groups: retentive anchors(B), magnets(M) and locator system (L).All patients rated with the aid of questionnaires their general satisfaction as well as other features of their dentures (esthetic, comfort, stability, ability of chewing, speech and cleaning ability) prior to the treatment and at 6 and 12months. Results: All the groups had less oral health related quality of life problems than before treatment. Conclusions: Rehabilitation with implants produces a significant improvement in the esthetic apparence, satisfaction level and the masticatory capacity for elderly patients, despite the fact that the retention force of the magnet attachment is smaller.

Acknowledgments: Supported by ITI Foundation for the Promotion of Oral Implantology, Switzerland, Grant no.316/2003 and no.507/207.

Tratamentele cu laser CO2 in rinitele cronice

Dr. Tanasescu Ioana, medic primar O.R.L., Dr. Andrian Iustina, medic primar O.R.L., C.M.D.T. al S.R.I.

Rinitele reprezinta afectiuni inflamatorii ale mucoasei nazale datorate unor numeroase cauze, clasificate astfel:

a. Dupa criteriul temporal (acute si cronice)b.Etiologic (infectioase, alergice, nonalergice,

noninfectioase)c. Dupa varsta (nou-nascuti, sugar, copil, adult, varstnic)

Rinitele cronice reprezinta inflamatiile prelungite peste trei saptamani ale mucoasei nazale insotite de alterari histopatologice ce pot evolua spre ireversibilitate. Clasificarea rinitelor cronice se face astfel: nespecifice (banale, catarale, hipertrofice sau atrofice) si specifice (TBC, sifilis, micoze, granulomatoze).Rinitele cronice hipertrofice reprezinta inflamatiile cronice ale pituitarei insotite de degenerescenta hipertrofice si edematoasa a acesteia. Exista doua forme anatomopatologice descrise: localizata (cap, corp, coada de cornet nazal inferior) si difuza (intreaga mucoasa nazala). Exista trei stadii evolutive: hipertrofia moale, hipertrofia conjunctiva (partial reversibila) si degenerescenta edematoasa ireversibila a mucoasei. Intre rinitele cronice de alte etiologii citam: rinitele postmedicamentoase (rinita indusa de picaturi decongestionante,

de anticonceptionale, hipontensoare), hormonale (hipotiroidie, sarcina), pozitionala, vasomotorie, rinita varstnicilor.Simtomatologia clinica imparte pacientii in doua categorii:

a. pacienti care stranuta – au rinoree apoasa, congestie nazala, conjunctivala, simptome ce sunt mai frecvent dimineata

b. pacienti ce au obstructie nazala fara stranuturi sau rinoree, simptime mai pregnante noaptea.Diagnosticul pozitiv se formuleaza pe baza anamnezei, a examenului local O.R.L., a testelor alergice cutanate, imunologice, fibroscopiei rinofaringiene, rinomanometriei, olfactometriei, biopsiei de mucoasa, analizelor sanguine.Complicatile rinitelor alergice sunt rare, totusi ele pot fi asociate cu sinuzite si astm bronsic. Cauzele posibile ale acestor asocieri pot fi: identitatea epiteliului pe tot tractul respirator, transmiterea genetica a terenului alergic, prezenta reflexului rinosinusobronsic.

Clasificarea etiologica a rinitelor cronice

Tratamentul rinitelor alergice include: corticoizi topici, antihistaminice orale si locale, decongestionante locale, pacientului indicandu-i-se evitarea alergenilor cunoscuti (polen, praf, puf, par de animale, etc..). o cura scurta de corticoterapie sistemica la pacientii cu rinita sezoniera severa poate fi benefica in multe situatii. Imunoterapia produce o scadere a IgE, cresterea IgG si de administreaza sub forma de solutii locale pe mucoasa mazala. Tratamentul topic cu corticosteroizi ( de tipul Flixonase, Rhinocort, Nasonex) administrate de 1-2 ori pe zi au efect antiinflamator, antialergic, decongestiv in rinitele cronice rezistente la celelalte tratamente. Rinitene nonalergice au raspuns slab la antihistaminice si decongestionante, imunoterapia nu are efect, totusi raspunsul la corticosteroizi locali este favorabil.Procedeele chirurgicale rezolva tulburarile anatomice si cauzele de obstructie nazala prin adenoidectomie, repozitia septului deviat, mucotomia cornetelor nazale, polipectomie, drenajul sinusurilor. Inca din anii 1980 diferite tipuri de lasere chirurgicale au fost folosite pentru a reduce dimensiunile mucoasei nazale, alaturi de tratamentul chirurgical (mucotomie clasica si electrocauterizare si criocauterizare). Laserul CO2 a luat loc cu succes electrocauterizarii cornetelor nazale inferioare, crioterapiei, turbinectomiei clasice care sunt sangeroase, dureroase, necesitand internare in spital, tamponament anterior si posterior, putand produce sinechii septoturbinale. Laserul CO2 este cel mai frecvent folosit in patologia O.R.L. deoarece raza laser este usor absorbita de apa, iar mucoasele din sfera O.R.L. sunt bogate in apa. Cornetul nazal inferior este partea cea mai importanta a valvei nazale fiziologice. Avand o structura cavernoasa si o inervatie neurovegetativa ea se comporta ca un sfincter, asigurand debitul, umiditatea, incalzirea si purificarea fluxului aerian. Interventia cu laser CO2 la nivelul cornetului nazal inferior este indicata in cazul oricarui tip de rinite cronice insotite de obstructie nazala.

Material si metoda – in decursul a zece ani (1998 – 2007) au fost tratati si urmariti in cabinetul O.R.L. al C.M.D.T. 500 de pacienti prin vaporizare laser CO2 a cornetului nazal inferior. Repartitia pe sexe a fost 70% barbati, 30% femei, iar pe grupe de varsta 80% intre 30 si 50 de ani si 20% peste 50 de ani.Grupele etiopatogenice selectionate au cuprins pacienti alergici cronici 25% si nonalergici 75%.Din grupul nonalergic de pacienti cu rinita cronica peste 60% au fost cei dependenti de picaturi decongestionante (Bixtonim, Rinofug), rinita pozitionala (10%), rinita varstnicului (10%), rinita vasomotorie (20%).Rinitele asociate cu obstructie locala a fosei nazale prin deviatie de sept nazal sau concha bulosa si rinosinuzite cronice au fost completate ca tratament prin procedee chirurgicale (10% din cazuri).

Interventii laser, Repartitia pe sexe

46





Cazuistica dupa etiopatogenie

Chirurgia laser CO2 a cornetului nazal inferior a fost efectuata in cabinetul O.R.L. fiind precedata de anestezie locala cu Xilocaina 10%. La 90% din cazuri s-a aplicat fasciculul laser CO2 pe capul cornetului inferior cu o putere de 9-12 W puls intermitent, iar in 10% din cazuri pe coada cornetului inferior cu dispozitive flexilase, in puls continuu (10 W).Tratamentul laser CO2 a hipertrofiei de cornet nazal inferior nu a fost urmat de sangerari sau dureri postoperatorii. Vindecarea completa aparuta dupa doua saptamani de la interventie a fost precedata la 7 zile de extragerea crustelor sanguinolente formate in fosele nazale cu imbunatatirea respiratiei.Pacientii au avut o evolutie favorabila in 60% din cazuri pentru urmatorii doi ani iar in 40% din cazuri au avut o evolutie partial favorabila (din acestia, jumatatea au revenit pentru o noua terapie laser la 6 luni iar restul de 50% au necesitat completarea cu alte tratamente (Rhinocort, Diprophos) ).

Evolutia post-interventie laser

Concluzii: durata scurta a interventiei chirurgicale laser, rezultatele favorabile, efectele secundare minore au condus la o adresabilitate mai crescuta a pacientilor fata de procedeele chirurgicale clasice (dureroase si sangerande), desi acestea s-au dovedit mai eficiente pe termen lung decat chirurgia laser.Bibliografie

· R. Calarasu, T. Antaman, V. Zainea – Manual de patologie ORL si chirurgie cervicofaciala - 2000

· C. Sarafoleanu – Manual rinologie – 2003· J.A.S. Carruth, G.T. Simpson - Lasers in Otolaryngology

Laser CO2 surgical treatment in

hyperplastic inferior nasal turbinatesDr. Tanasescu Ioana, medic primar O.R.L., Dr. Andrian Iustina, medic primar O.R.L., C.M.D.T. al S.R.I.

Chronical rhinitis are determined by an over three week inflammation of the nasal mucosa followed by irreversible morpho-pathological changes.Chronical rhinitis can be classified in the following ways:

a. by the temporal criteria (acute, chronical)b. ethiological (infectious, allergic, nonallergic,

noninfectious)c. by age (newborn child, adult, elder)

Chronical hypertrophical rhinitis are the chronical inflammations of the nasal mucosa followed by edema and hypertrophical changes (soft, conjunctival – reversible and irreversible). By the place of the hypertrophy it can be on the head, body or tail of the inferior

turbinates. Other possible causes of the inferior rhinitis can be drug induced rhinitis, hormonal, vasomotor, positional or age related rhinitis.The simptomatology of the patients has two characteristics

a. patients who sneeze, with aquous rhinoreea, nasal and conjunctival congestion, more frequent in the morning

b. patients with nasal obstruction without sneezing or rhinoreea, more frequent in the night

Etiological classification of chronic rhinitis.

Chronic turbinate hypertrophy and nasal obstruction are commonly associated with rhinitis, the inflammation of the mucous membranes of the nose. When the mucosa becomes inflamed the blood vessels inside the membrane swell and expand causing the turbinates to become enlarged and obstruct the flow of air through the nose.Chronic enlargement of the turbinates and the accompanying symptom of nasal obstruction affect people throughout the day as well as during sleep. A chronic stuffy nose can impair normal breathing, force the patients to breathe through the mouth and turn the simple acts of eating, drinking and speaking into an annoying and sometimes painful experience.Allergic rhinitis and perennial allergic rhinitis occurs when an individual is exposed to allergens in the environment (pollens, animal dander, molds).Vasomotor rhinitis results from this function of the nerves that control the nasal mucosa.The turbinates of a patient with vasomotor rhinitis can overreact to changes in external temperature and humidity. Irritative rhinitis occurs when the nose becomes hyper reactive to irritants such as cigarette smoke, chemicals, dust, strong odors.Drug induced rhinitis is usually due to excessive use of nasal sprays or nose drops administered in response to nasal obstruction. The positive diagnosis is given by the history of the patient, the local ENT exam, allergic tests, rhinofaringean fibroscopy, rhinomanometry, mucosal biopsy, blood tests.Chronic rhinitis can be associated with sinusitis and bronchial asthma.The treatment includes antihistamines (local and oral), decongestants, cortico steroids (nasal sprays such as Flixonase, Rhinocort, Nasonex), immuno therapy.Surgical treatments of enlarged turbinates that cause chronic nasal obstruction is indicated only after patients fail to respond to medical therapy. Turbinate surgery can be performed as an office procedure under local anesthesia or in the operating room under general anesthesia.Even since 1980 several types of surgical lasers have been used to reduce the enlarged turbinates. The CO2 laser took successfully place to the electrocautery, criotherapy, classic turbinate resection, which are painful, followed by bleeding and need nasal packing and a prolonged crusting and healing.CO2 laser is frequently used in ENT pathology because the laser beam is easily absorbed by water and the ENT mucosa is full of water. The laser CO2 procedure over the nasal inferior turbinates is indicated in any kind if chronic rhinitis followed by nasal obstruction.





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Materials and methods used – During 10 years (1998 – 2007), 500 patients were followed up and treated with a CO2 laser as an outpatient procedure under local anesthesia. The patients where 70% male and 30% female, being 80% aged between 30 and 50 years old and 20% over 50.The selected etiopathogenic groups were 25% allergic rhinitis and 75% non-allergic. In 90% of cases the CO2 laser beam application was on the head of the inferior nasal turbinates using a laser beam of 9-12W intermittent application and 10% on the tale (using the Flexilase – 10W).The CO2 laser surgery was performed in the ENT office, under local anesthesia with 10% Lidocain.

No complications like bleeding or edema were observed during operation or postoperatively.The patients had satisfactory results in 60% of cases for the next two years whereas 40% needed further treatment.

Conclusions: The good results, minor side effects, the short operation time made the addressability of patients increase towards laser therapy compared to the painful and bleeding classical invasive surgical methods (although the last ones seemed to be more effective than laser surgery in the long term).

Patients by gender

Ethiopatogenic classification

Results after laser surgery

Leficienta in rejuvenarea si resurfacing-ul pielii prin tehnica fraxel a luminii vizibileintens pulsate C.Solovan, Maria Ciolan, Maria Iordache

De acum 2-3 ani cind s-a lansat laserul cu tehnologia Fraxel pentru rejuvenare si resurfacing-ul pielii, s-au dezvoltat mai multe variante. Se cunoaste faptul ca pielea absoarbe predominant la lungimile de unda de:1925nm, 1540nm, 1430nm si 410nm. Experimental lumina intens pulsata in forma principiului fraxel ( Photomatrix by Photonova) produce, la un nivel ridicat de energie, leziuni similare cu cele ale laserului de tip Fraxel. Leziunile au avut amploarea cea mai mare la jonctiunea dermo-epidermica si imediat subiacent in dermul superior. Leziunile histopatologice constau in degenerarea epidermului si a dermului superior cu efect stimulativ pe sinteza de colagen adiacenta, dar si decolarea focala a epidermului fata de dermul subiacent. Pe pielea umana efectul a fost prompt in 24 de ore cu remisie in 5 zile.Studiul nostru a fost efectuat cu platforma PLS3(fractional skin resurfacing with IPL-Photomatrix) PM450, cu energie inalta si filtru la 400nm. Pacientii cu virsta cuprinsa intre 34-64 ani au fost supusi unei singura sedinte. Evaluarea s-a efectuat la 2 saptamini si a constat in fotografii si evaluari de catre pacient si 2 dermatologi(scara a fost dupa cum urmeaza : 0 =fara ; 1=subtil ; 2= important;3=excelent).Sistemul Photomatrix s-a dovedit a fi un sistem eficient pentru rejuvenarea si resurfacingul pielii. Utilizarea luminii vizibile permite operatorului sa selecteze diferite filtre si parametrii spre a induce resurfacing-ul pielii, necroza de coagulare sau stimularea termica. Observarea de rezultate vizibile inca dupa prima sedinta demonstreaza cu unitatea este utila, cost-efectiva, versatila si usor manevrabila, intre sistemele de tratament de tip fraxel ale pielii.

LEfficacy in rejuvenation and resurfacing of the skin by the fraxel tehnique of intens pulse light

C.Solovan, Maria Ciolan, Maria Iordache

Since 2-3 years ago when the Fraxel laser was launched for skin rejuvenation and resurfacing, many variants were developed. It is known that the skin absorbed predominantly at the wavelength of: 1925nm, 1540nm, 1430nm and 410nm. Experimentaly the visible pulsed light in form of fractional principle (Photomatrix by Photonova) produced at high level of energy, lesions similarly to that of Fraxel lasers. The degree of the lesions were high at the dermo-epidermal junction and underneath. The histopathologic lesion consist of degeneration of epidermis and the upper dermis with stimulative effect of new collagen synthesis beneath, decolation of the epidermis from the upper dermis. On human skin the effect was prompt in 24 ours and with remission in 5 days. We have performed a clinical study with PLS3( fractional skin resurfacing with IPL-Photomatrix) PM450, at high energy level, with filter at 400. The patients treated in one session were aged 34-64. The evaluation was performed at 2 weeks by means of photographs and evaluated by patients and two dermatologist( the scale was: 0=none;1=subtle;2=important;3=astonishing).The Photomatrix system has proven to be an effective device for Fractional Resurfacing of the skin.The use of visible light enables the operator to select different filters or parameters to induce resurfacing, coagulative necrosis or thermal stimulation.The observation of visible results after one session may prove this device will be a useful, cost-effective, versatile and friendly to use fractional skin therapy.





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Rolul laserului Dye in dermatologie- 11 ani de experientaAlin Nicolescu- C.M.D.T. RomaIrinel Nedelcu- Spitalul Colentina

Aparitia laserului Dye a insemnat un pas important in terapia dermatologica. El reprezinta in continuare tratamentul de electie al angioamelor, dar are si multe alte indicatii, cum ar fi: angiokeratoame, telangiectazii, cuperoza, poikilodermie, veruci( cu mentiune speciala pentru cele periunghiale), psoriasis, lichen cornos, leziuni pigmentate.

Ecografia cutanata- metoda diagnostica in continua dezvoltareAlin Nicolescu- C.M.D.T. RomaIrinel Nedelcu- Spitalul Colentina

De-a lungul timpului ecograful cutanat si-a demonstrat de nenumarate ori eficienta. Lucrarea prezinta cateva cazuri in care aceasta metoda neinvaziva a fost utilizata in scop diagnostic, postoperator, dar si pentru urmarirea evolutiei postterapeutice( alopecii, psoriasis, eczema, lipodistrofie etc).

TRATAMENTUL ANGIOAMELOR CU LASER DYE


In opinia noastra Laserul Dye reprezinta in continuare singura metoda reala si sigura in tratamentul angiamelor. Lungimea de unda de 585 nm asigura o absorbtie maxima a energiei de catre oxihemoglobina, avand astfel ca tesut tinta formatiunile vasculare. Penetrarea in tesuturi a energiei fotonice a acestui tip de laser se realizeaza cu un mare grad de siguranta pentru pacient, astfel incat efectele secundare de tipul atrofiei apar doar exceptional.

Lucrarea de fata aduce in atentie experienta de peste 10 ani de zile a autorilor in tratamentul diverselor forme clinice de angioame cu localizari variate. Vindecarea se obtine fara atrofie si fara tulburari de pigmentare.

Eficienta terapiei laser Dye a angioamelor comparativ cu alte metode


Laserul Dye este considerat tratamentul de electie al angioamelor, in toate studiile effectuate, cu diverse metode terapeutice, laserul cu lungime de unda 585 nm are cele mai bune rezultate, atat din punct de vedere therapeutic, cat si cosmetic.Prezentam cazuri tratate cu aceasta metoda, comparativ cu alte metode de tratament al angioamelor.

Tratamente alternative in alopecia areata


Alopecia areata este o afectiune care prezinta inca numeroase necunoscute. In acelasi timp impactul psihologic asupra pacientului, dar si al anturajului, este impresionant. De multe ori tratamente hazardate pot agrava evolutia bolii, de aceea se cauta continuu solutii terapeutice eficiente cu riscuri minime. Prezentam utilitatea unor tratamente alternative, neincluse inca in arsenalul de tratament uzual al peladei.

Implantul de par, actualitati


Implantul de par propriu se foloseste de peste jumatate de secol in tratamentul alopeciilor ireversibile. In ultimii ani, prin evolutia tehnicii chirurgicale, s-a ajuns la folosirea unitatilor foliculare si la implantarea de grefe cu un singur fir de par, ce pot fi recoltate din orice regiune paroasa a pielii, permitand obtinerea de rezultate estetice spectaculoase.

Progresele facute recent in cultura de foliculi pilosi, face ca aceasta tehnica sa promita disparitia neplacerilor estetice produse de alopecii.

Locul laserului CO2 in tratamentul nevilor melanocitari


Laserul CO2 este un laser chirurgical de mare utilitate in cabinetele de dermatologie . Datorita multiplelor avantaje s-au raspandit tot mai mult in tratamentul diverselor leziuni si tumori cutanate.De multe ori ne vedem in situatia de a alege intre excizia laser cu superpuls, vaporizarea laser in modul continuu sau excizia cu bisturiul a unei tumori nevice. Intrucat in cadrul specialitatii noastre, Dermatologia, sunt controverse pertinente in abordarea acestor tumori, propunem cateva conditii clare, obiective si accesibile( forma clinica, localizarea, tipul pielii, dermatoscopia, ecografia cutanata) pe baza carora sa alegem una din cele 3 metode.

Treatment of Acne Scars and Skin Rejuvenation with 1440 nm Anti-Aging Wavelength with Combined Apex Pulse (CAP) Technology.

The visual signs of superficial photoaging are typically confined to the epidermis and upper dermis (100-300 µm) resulting in the typical pattern of the textural changes, fine lines, acne scars and skin rejuvenation.New fractional techniques have proven to be an effective means of showing an improved outcome with minimal downtime. Common treatments have included the CO2 laser and the Er: YAG laser.These lasers have their advantages, and as a result they complete the epidermis and dermal damage to encourage reepithelialization with new epidermis and reorientation of collagen in dermis.However, few patients tolerate the postoperative “downtime” and permanent hypopigmentation associated with these devices. Other compl icat ions include prolonged erythema, hypopigmentation with people of skin types IV and more, acne flares and dermatitis. To overcome these disadvantages the only solution in our opinion is the new generation with a 1440nm Nd: YAG laser device with Combined Apex Pulse (CAP) technology. The systems 1440nm wavelength is the most effective in our opinion at targeting the band of solar elastosis found 100-300 µm in the dermis. Furthermore the systems CAP was developed to combine the effects of both high-fluence aggressive heating resulting in collagen remodeling and the mechanism of low-fluence low level heating resulting in collagen stimulation. This diffractive array redistributes the energy to be delivered onto the skin avoiding epidermal damage.

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Methods:Twenty two patients (twenty women) aged 28, 8 +_ 19, 3 years seeking improvement in acne scars and skin laxity with skin types from II-IV. Subjects were evaluated prior to the initiation of treatment and prior to each subsequent treatment.Subjects received at least five treatments at two-week intervals using system at 1440nm wavelength, 3-msec pulse duration, and 10-mm or 14-mm in difficult cases diameter CAP array. Treatment fluences range with 10-mm diameter 3-5, 5 j/cm2 and 14-mm 3-4 j/cm2. Treatment areas received between two and three treatment passes, with areas of greater visual defects receiving more passes. A cooling device ECOCOOL D attached to the handpiece was set at 2 to 4 during each treatment. No additional anesthesia was required. The CAP array requires full contact with the skin for appropriate treatment. Few times a test spot was done on subjects with skin type III and IV. Subjects were instructed to avoid sun exposure for several days before and after each treatment.From all twenty-two cases in three patients treated areas became tan or dusky 36-72 hours after treatment. In two patients' cases, the treated areas under eyes there appeared an edema which became dusky for 48-72 hours after treatment. This transient discoloration resolved within 2 weeks in affected subjects. Typical initial response and edema resolved within hours to a few days. There were no scars, hyper or hypopigmentation observed even in subjects with skin type III-IV. Global improvement was grated according to the following scale: 1= 0%-25%; 2=26%-50%; 3=51%-75%; 4=76%-100%.Results:Twenty patients achieved 78% to 100% overall improvement and two patients achieved 51% to 75% overall improvement. Adverse effects were limited to mild temporary erythema and edema for several hours after treatment. Only in five cases the erythema stayed longer than 48 hours. While evaluating the treatment of twenty two patients using the 1440nm Anti-Aging wavelength with Combined Apex Pulse an improvement in acne scars and in skin laxity was noted. Patients tolerated the procedures well and were very satisfied with the results.Discussion:The improvement data and the photographs show that most subjects received three to five treatments with the 1440nm laser achieved 76% to 100% global improvement. A clinical factor in achieving collagen construction is the depth of energy penetration. In solar elastosis, bindles of loosely packed, haphazardly organized collagen are present in the dermis at depths ranging from 100 to 300 microns. This indicates that a laser whose energy penetrated up to 300 microns would safety and effectively treat solar elastosis and than deeper penetration is not necessary. Depending on influence, CAP energy penetrates up to 300 microns to the papillary dermis where most damage occurs. This means that the treatment effect in the acne scars will be the most effective with such lasers.Other advantages are that the time of 15 minutes which is approximately required for a full face treatment is much less than other microrejuvenation procedures. In addition, clinical applications are expanding to other scar types, wrinkles and pigmentation.This new technology has proven to be a good compromise between full ablation and previous non-ablative IR resurfacing devices.Conclusion: The new 1440nm Anti-Aging wavelength with CAP technology provides significant improvement in acne scars and skin rejuvenation and offers significant practical advantages over the microrejuvenation technique. The micro-thermal injury CAP ability shows promise of many different ways to achieve efficacy, though it is still early in developing best parameters. In addition, clinical applications are expanding to other scar types, wrinkles, and pigmentation. The new 1440nm laser has proven to be a good compromise between full ablative and previous non-ablative IR resurfacing devices.

RINOFIMA TRATATA CU LASER

Prezentare de caz Bogdan-Dimitrie NIculae MD Bsc, Bogdan Savu M.D., Lavinia ZALUPCA MD PhD

Pacient: M.A.. barbat, 59 de ani Diagnostic: rinofima de dimensiuni medii. Tratament preoperator: Tratament medicamentos

(antibiotice, AINS si medicatie anti-virala) pentru reducerea portiunii inflamatorii. In locul vechii proceduri - decorticarea nasului - am preferat un laser cu CO2 la o putere de 15W cu unda continua si in mod defocalizat. Tehnica tratamentului laser: ablatie strat cu strat (vaporizare) a hipertrofiei glandelor sebacee sub anestezie locala (tronculara), dar nu prea adanca din cauza riscului de a produce o cicatrice inestetica.

Tratament postoperator: unguent cu antibioticsi pansament neaderent. Curatarea plagii cu peroxid (3x/zi).

Rezultate: Reepitelizarea a fost completa in 4 saptamani. Eritemul reactiv si un mic grad de edem raman pentru 2 luni. Rezultatul estetic a fost perfect. Nasul a fost readus la fosrma initiala fara sa apara cicatrici.

Particularitatea cazului: tehnica speciala necesara acestei afectiuni si necesitatea unui operator antrenat.

Concluzii: laserul cu CO2 utilizat in mod continuu si defocalizat este capabil sa indeparteze eficient, sigur si estetic intreaga leziune, in conditiile utilizarii tehnicii adecvate de catre un operator antrenat. Principalele avantaje ale tehnicii sunt: gradul mare de precizie si camoul operator fara singe

RHINOPHYMA TREATED WITH CO2 LASER

Case report Bogdan-Dimitrie NIculae MD Bsc, Bogdan Savu M.D., Lavinia ZALUPCA MD PhD

Patient: M.A.. male, 59 years old Diagnosis: moderate - sized rhinophyma. Pre-treatment care: medical therapy (antibiotics, AINS

and anti-viral medication) for clearing of the inflammatory portion. Instead of the old procedure - decortication of the nose - we prefered a CO2 laser at 15W with a continuous beam in a defocused mode. Laser treatment - technique: Layer by layer ablation (vaporization) of the sebaceus gland hypertrophy under local anesthetic (nasal block), but not too deep due to the risks of a poor scar.

Post - treatment care: antibiotic ointment and non-adherent gauze. Cleaning of the wound with peroxide (3x/day).

Results: Re-epithelialization was complete in 4 weeks. Reactive erythema and a small degree of swelling remain for 2 months. The aesthetic result was perfect, the nose was reshaped without scars.

Particularity of the case: the special technique according with this condition and the necessity of a skilled operator.

Conclusions: CO2 laser used in CW and defocused mode are able to remove effective, safe and aesthetic the entire lesion, with the right technique and by a skilled operator. The main advantages of the technique are the high degree of precision and the completely bloodless field

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PRODUSE COSMETICE ANTI-AGING PE BAZADE ANTIOXIDANTI NATURALI DE ORIGINE VEGETALA

St. Manea, V.Carabela, V. Tamas, G. Alexandru, D.Ionescu

Avand in vedere noile concepte in biologia pielii si a parului, ingredientele active noi pentru improspatarea, protectia si regenerarea pielii, tehnologiile de formulare avansate legate de stabilitatea emulsiilor si a produselor, precum si aspectele privind masurarea eficacitatii si sigurantei ingredientelor active si produsului final, SC HOFIGAL SA a realizat o noua gama de produse cosmetice” HOFIGAL-ACTIV”, pe baza de antioxidanti naturali de origine vegetala.Linia de produse biocosmetice “HOFIGAL- ACTIV” este destinata cresterii eficientei produselor HOFIGAL in ingrijirea si intretinerea pielii cu rol principal de :-prevenire a proceselor de imbatranire prin antioxidantii naturali folositi;- hidratare profunda si de stimulare a metabolismului colagenic si cutanat;- protectie fata de factorii agresivi din mediul inconjurator.Antioxidantii naturali prezenti in extractele vegetale, asigura protectia optima a pielii impotriva efectelor daunatoare ale radicalilor liberi, responsabili de procesul de imbatranire prematura, actionand in cadrul compartimentelor intra- si extracelulare. Valorificarea fructelor, radacinilor si frunzelor unor specii de plante indigene au pus in evidenta continutul bogat in carotenoide, polifenoli, flavonoide, vitamine lipo si hidro-solubile, acizi triterpenici, oligoelemente cu potential antioxidant remarcabil.Complexul activ “Anti- aging” din gama de produse cosmetice ”HOFIGAL-ACTIV” contine: - extract din frunze de catina (Hippophae rhamnoides);

-extract de seminte de struguri(Vitis vinifera); -extract de lemn dulce(Glycyrrhiza glabra) ; -extract de oregano ( Origanum majorana); -vitamine ( vitaminele A, E si C)Compozitia complexa si variata a acestor extracte

determina efectul antioxidant si de reechilibrare a statusului redox al pielii, de refacere a matricei intracelulare; previne imbatranirea prematura a pielii, incetineste procesul de imbatranire biologica si atenueaza ridurile deja formate.

Linia de produse biocosmetice “HOFIGAL- ACTIV” cuprinde:Produse de ingrijire si intretinere faciala pentru toate tipurile de ten: Lapte demachiant stimulant Lotiune tonifianta Crema hidroactiva de zi Crema nutritiva de noapte Crema emolienta pentru contur ochi Crema pentru prevenirea si atenuarea ridurilor Masca de fata revitalizanta Masca de fata nutritivaProduse de ingrijire si intretinere corporala: Crema de masaj Gel de baie relaxant si revigorant

Produsele sunt realizate pe baza de ingrediente de inalta puritate si substante active naturale, cu mare eficacitate si afinitate fata de piele.

Ele sunt combinate dupa criterii stiintifice cu materii prime de maxima puritate, in formule cu textura ultrabogata .

Produsele se adreseaza unui segment larg de consumatori, cu varste de peste 20 ani si sunt concepute pentru toate tipurile de ten, asigurand un tratament de ingrijire si intretinere eficient si durabil, atat pe timpul zilei cat si pe timpul noptii

ANTI-AGING COSMETIC PRODUCTS BASED ON NATURAL PLANT-ORIGIN ANTIOXIDANTS

St. Manea, V.Carabela, V. Tamas, G. Alexandru, D.Ionescu

With a view to new concepts in the biology of the skin and the hair, the new active ingredients for the freshening, protection and repair of the skin, advanced formulation technologies tied to the stability of emulsions and of products, as well as aspects regarding the measurement of the safety and efficacy of the active ingredients and the final product, SC Hofigal Export-Import SA have created a new range of cosmetic products “Hofigal-Activ”, based on natural plant-origin antioxidants.

The Hofigal-Activ range of biocosmetic products is specifically aimed at the care and maintenance of the skin with a principal role of:- preventing aging processes by the use of natural antioxidants;- profound hydration and stimulation of the collagenic and cutaneous metabolism;- protection from aggressive factors in the surrounding environment.Natural antioxidants present in plant extracts assure an optimal protection of the skin against the damaging effects caused by free radicals responsible for the premature aging process, acting as much intra- as extra-cellularly. The value-added utilisation of the fruits, roots and leaves of certain species of native plants have highlighted the rich content in carotenoids, polyphenols, flavonoids, lipo- and hydro-soluble vitamins, tri-terpenic acids, and oligoelements with a remarkable antioxidant potential.The active “anti-aging” complex from the Hofigal-Activ range of cosmetics contains:

- sea buckthorn leaf extract (Hippophae rhamnoides)- grape seed extract (Vitis vinifera)- licorice extract (Glycyrrhiza glabra)- oregano extract (Origanum majorana)- vitamins (vitamins A, E, and C)

The complex and varied composition of these extracts determines the antioxidant and redox-status balancing effect of the skin, for the repair of the intracellular matrix; it prevents the premature aging of the skin, it slows the biological aging process and it attenuates wrinkles that have already formed.The Hofigal-Activ range of cosmetics comprises:- Stimulating make-up cleansing milk- Tonifying lotion- Hydroactive day cream- Nourishing night cream- Emollient cream for around the eyes- Cream for the prevention and reduction of wrinkles- Revitalising face masque- Nourishing face masque

Body care and maintenance products- Massage cream- Relaxing and reinvigorating bath gel

The products are realised on the basis of very pure ingredients and natural active compounds, that have a great efficacy and affinity for the skin.

They are formulated with regards to scientific criteria for raw materials of the highest purity that have a very rich texture.

The product range is aimed at a large segment of consumers aged 20+ years. They are suitable for all skin types, assuring an efficient and durable care and maintenance treatment, for both the daytime and the night-time.





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ANTIOXIDANTI NATURALI IN TRATAMENTE “ANTI-AGING”Nora Radulescu, Elena Mazilu, Maria Mitru, Gabriel Ivopol

Teoria îmbătrânirii datorita excesului nociv de radicali liberi existenţi în organism a orientat atenţia producătorilor de suplimente alimentare şi medicamente naturale spre cercetarea unor compuşi naturali cu proprietăţi antioxidante, capabili sa capteze aceste mici fragmente moleculare extrem de reactive.

Lucrarea prezintă sistematizat pe tipuri structurale, clasificate concordant cu principiile chimiei organice, ansamblul de antioxidanţi naturali dezvoltat şi realizat în produse de către HOFIGAL şi anume:

- structuri polinesaturate (acizi graşi polinesaturaţi, coenzimă Q10, carotenoizi si terpene)

- polifenoli şi acizi polifenolcarboxilici- compuşi cu structură pirolică (ficocianine, ficobiline,

serotonine)- derivaţi sulfuraţi - polizaharide- vitamine hidro şi liposolubile- enzime - mineraleSunt efectuate corelări cu activitatea biologică care stau

la baza realizării unor tratamente raţionale şi diferenţiate pentru fiecare afecţiune asociată geriatriei.

Realizate prin tehnologii organice şi eficiente, analizate prin procedee fizico-chimice şi biochimice moderne, produsele firmei HOFIGAL pe bază de antioxidanţi naturali- sunt avizate, premiate de foruri naţionale si internaţionale şi cunoscute pe piaţa suplimentelor alimentare şi medicamente naturale de aproape 20 de ani.

Dintr-un mare număr de produse cu efect antioxidant- prezentate într-o lucrare separată, se menţionează doar câteva deosebit de valoroase în tratamentele anti-aging: Coenzima Q10 în ulei de cătină, Spirulină cu cătină, Ulei de peşte, Complet Antioxidant, Seleniu- Spirulină, Flavovit C.

NATURAL ANTIOXIDANTS IN ANTI-AGING TREATMENTS”Ing. chim. Stefan Manea, Maria Mitru, Gabriel Ivopol

The theory of aging due to excess of noxious free radicals present in the body, guided nutritional supplements and natural medicaments producers, to discover new organic compounds able to scavenge these dangerous molecular fragments.

This paper systematically presents on the basis of structural pipes, that are classified in accordance with the principals of organic chemistry, the entire palette of natural antioxidants developed and realised by HOFIGAL as follows:- polyunsaturated systems (polyunsaturated fatty acids, carotene derivatives, coenzyme Q10)- polyphenols , polyphenolcarboxylic acids and tannins- pyrole derivates (ficocyanins, ficobilins)- sulphur derivatives- polysaccharides- hydro and lipo-soluble vitamins- enzymes- minerals

Correlations are presented between structure and biological activity, accounting for a rational and selective therapy, in every disease associated with the geriatric problems.HOFIGAL's products are realized by organic and efficient procedures, analyzed with the aid of modern physico-chemical and biochemical methods. They are GMP approved, have received national and international awards, and well known on the natural nutritional supplements market.

From a great number of products existing in HOFIGAL's portfolio, certain products that are very useful in antiaging treatments are: “Coenzyme Q10 with seabuckthorn oil”, “Spirulina with seabuckthorn extract”, “Fish oil”, “Complete Antioxidant”, “Selenium-Spirulina”, besides many others.

PRODUSE NATURALE CU EFECT PROTECTOR CONTRA STRESULUI OXIDATIV IMPLICAT IN PROCESELE DE IMBATRANIRE

Manea Stefan, Viorica Tamas, Florian Ionescu

Preocupările firmei Hofigal pentru domeniul Geriatriei-Gerontologiei sunt bine cunoscute cu mulţi ani în urmă.

Un mare număr de produse naturale prezentate ca suplimente alimentare sunt oferite pieţei interne cât si externe, menite să îmbunătăţească prin prevenţie şi susţinerea tratamentelor severe chimio-terapice starea de sănătate a populaţiei şi să întârzie procesele de îmbătrânire.

Lucrarea de faţă aduce în prim-plan acele produse naturale care au ca principal efect reducerea consecinţelor dăunătoare ale stresului oxidativ asupra proceselor de îmbătrânire naturală sau prematură.

Prin compoziţia lor în substanţe biocompatibile, cu efect antioxidant, care au ca scop atât inhibarea formării în exces a radicalilor liberi, cât şi neutralizarea excesului format în anumite stări patologice, sau în cazul unei alimentaţii defectuoase, aceste produse sunt de mare ajutor.

Majoritatea acestora, au pe lângă componente cu efect antioxidant, o mare varietate de nutrienţi esenţiali, care prin sinergism menţin şi stimulează funcţiile vitale, contribuind eficient la regenerarea celulară a ţesuturilor diferitelor organe, prelungind performanţele fizice şi intelectuale ale organismului uman, ceea ce reprezintă întârzierea îmbătrânirii.

Principalele produse prezentate în cadrul acestei comunicări sunt structurate pe grupe de compuşi bioactivi, evidenţiind mecanismele acţiunilor benefice şi evaluările experimentale favorabile.

NATURAL PRODUCTS HAVING PROTECTOR EFFECT AGAINST THE OXIDATIVE STRESS INVOLVED IN AGING PROCESSES

Manea Stefan, Viorica Tamas, Florian Ionescu

In recent years, HOFIGAL's activities in the area of anti-aging research and development have become increasingly well known.

A large range of natural products that are presented as dietary supplements are offered on the national and international markets.

HOFIGAL's products aim to improve health by preventing illness , or if not possible, sustaining people undergoing e.g. chemotherapy. The improvement in people's health on a cellular level helps to slow the aging process.

This paper brings to the forefront those natural products that in the first instance reduce the harmful consequences that oxidative stress plays upon natural or premature aging processes.

Due to their composition in biocompatible substances that have an antioxidative and nutritive effect, HOFIGAL's products are very useful in combating degenerative ailments.

Most of HOFIGAL's products have , in addition to antioxidants components a great variety of essential nutrients that synergistically maintain and stimulate the body's health. These essential nutrients contribute to the cellular regeneration of various organ tissues, thus improving both physical and intellectual performances, which means delayed aging.

The main products presented in this communication are structured on the basis of groups of bioactive compounds highlighting the mechanisms of the beneficial activities and the favourable experimental evaluations.





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Antioxidanti în Cosmetica

Dipl. Chem. Juncan A. M. Prof. Dr. Hodiş an T.

Cosmeticele sunt produse disponibile comercial, folosite pentru imbunătăţirea aspectului pielii. În ultimul timp, cererea consumatorilor pentru produse mai eficiente, care înfrumuseţeaza substanţial aspectul pielii, a dus la o intensificare a cercetării şi dezvoltării de produse în industria cosmetică. Rezultatul a fost o dezvoltare a mai multor materii prime în acest sens, care duc la o reală îmbunătăţire, nu doar al aspectului pielii, dar şi a stării de sănătate a acesteia. Acum se găsesc pe piaţa, produse care nu numai curăţă, protejează şi hidratează, dar care şi înnoiesc, refac şi întineresc epiderma [1]. În momentul de faţă, maximul de atenţie este acordat utilizării în formulările cosmetice, vitaminelor şi antioxidanţilor.

1. Definiţia AntioxidanţilorConform Directivei 95/2/EC din 20.02.1995 [1]- Antioxidanţii sunt substanţe care prelungesc durata de păstrare a produselor alimentare, prin protejarea lor faţă de deteriorarea cauzată de oxidare (râncezire sau modificarea de culoare).Pentru a nu se face greşeli de traducere dintr-o limbă în alta a denumirii substanţei folosite ca şi aditivi alimentari, precum şi pentru uşurarea inscripţionării acestora pe etichetele produselor, Comisia Codex Alimentarius a adoptat pentru uzul internaţional, Sistemul Internaţional de Numerotare a Aditivilor Alimentari, folosind aceleaşi numere ca şi Comunitatea Economică Europeană [2].În Europa numărul aditivului alimentar este precedat de către litera E, iar folosirea unui aşa zis Cod E de către Comunitatea Economică Europeană indicând faptul că substanţa respectivă: - este un aditiv, prima cifră indicând natura aditivului- a fost testată şi s-a dovedit sigură pentru consum- a fost înregistrată ca aditiv permis la forurile de specialitate.

Tabelul 1: Compuşi utilizaţi ca şi Antioxidanţi în Cosmetică si Industria Alimentară

2. Clasificarea AntioxidanţilorAntioxidanţii se clasifică în mai multe clase:a).după natura lor antioxidanţii se clasifică în: - antioxidanti naturali- antioxidanţi sintetici

b). După funcţia lor principală:- antioxidanţi propriu-zişi- substanţe care au acţiune antioxidantă, dar care prezintă în egală măsură şi alte funcţii [3].

3. Alegerea Antioxidanţilor în CosmeticăSubstanţele folosite pentru prevenirea râncezirii au fost folosite din 1843, de către Deschamps.Un antioxidant ar trebui să posede anumite proprieţati fizice si fiziologice, dacă se presupune ultilizarea acestuia in practica cosmetică, farmaceutică sau alimentară:* ar trebui să fie pe cât posibil neutral in reacţie;* ar trebui să fie uşor solubil in substrat;* trebuie săfie sigur din punct de vedere farmacologic şi trebuie sa nu fie toxic pentru tesuturi animale [4].Aceşti compuşi pot fi aplicaţi în preparate cosmetice, cu observţia că antioxidantul trebuie să efectueze inocuitate dermatologică şi să nu prezinte efecte primare de iritare şi sensibilitate:

» pielea este adesea sensibila in afront cu aceste substanţe

» un caz particular, este cazul rujurilor, în care se presupune o consideraţie deosebită in alegerea unui compus antioxidant adecvat, din cauza ca acest produs s-ar putea a fi ingerarat. Utilizarea antioxidantilor in cosmetică, se poate face, fie individual sau ca şi amestec de antioxidanti, când puterea antioxidantă creşte.

4. Aplicaţii Cosmetice: Concepte şi FormulăriVitamina A (Retinyl Palmitate), C (Ascorbic Acid) şi E (Tocopherol sau Tocopheryl Acetate) sunt cei mai populari antioxidanţi în produsele de ingrijire a pielii [5].În produsele pentru ingrijirea a pielii, şi in special in produse pentru protectie solară, Tocopherolul şi Tocopheryl Acetatul au o importantă deosebită, datorită proprietaţilor acestora: catifelează piela; previn îmbătrânirea prematură a pielii prin blocarea peroxidarii lipidice; reduce distrugerea celulelor si tesuturilor, induse de radiatii UV; posedă proprietăţi anti-inflamatoare; inhibă formarea eritemei cauzată de radiaţii UV, in special după aplicări repetate.

5. Mechanismul de Acţiune şi Funcţia Tocoferolilor ca şi AntioxidanţiFormulările cosmetice, conţinând uleiuri şi grăsimi, in special cele caracterizate printr-un numar mare de legaturi nesaturate sunt susceptibile deteriorării oxidative.Valoarea peroxidică este unul dintre cele mai importante criterii utilizata pentru monitorizarea procesului de oxidare: in cursul oxidării, valoarea peroxidică creşte dintâi foarte incet (perioada de inducţie), iar când aceasta atinge finalul, valoarea peroxidică creşte foarte rapid şi semne ale deteriorării devin evidente [6].Eficactatea antioxidantilor este exprimată ca si factor protectiv (protective factor), (PF):

Figura 1: Clasificarea Antioxidanţilor





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Considerând inhibarea oxidării lipidice, antioxidanţii pot fi:- substanţe care inhibă propagarea pasului de autoxidare sau- antioxidanţi preventivi [7], [8], [9].

Figura 2: Etape în Degradarea Produselor Cosmetice

5.1 Factorii care produc râncezireaAntioxidanţii sunt influenţaţi de anumiţi factori de mediu interni si externi, care pot contribui la distrugerea efectului antioxidant [3].Aceştia pot fi:» condiţii de temperatură » presenţa de ? caldură ? lumină ? oxigen.5.2 Activitatea Antioxidantă a Tocoferolilor Activitatea antioxidantă a Vitaminei E este bazată pe usurinţa cu care hidrgenul din gruparea hidroxil a cilului chroman poate fi donat pentru a neutraliza radicali liberi (creând un radical tocopheroxyl mai stabil) [10], [11], [12].

Figura 4: Scala Activităţii Antioxidante a Tocoferolilor

Figura 3: Mecanismul de Reacţie a Antioxidanţilor

6. Metode de Extracţie a AntioxidanţilorCel mai important pas in analiza chimică a antioxidanţilor este extracţia. Pentru a analiza aceşti compuşi este necesar a-i separa dintâi de matrice [13], [14], [15]. Două principii majore sunt utilizate pentru extracţia antioxidanţilor de matrice:

extracţia directă a antioxidanţilor fară saponificarea grăsimilor

extracţia antioxidantilor după saponificarea grăsimilorAceste două metode de extracţie utilizează la rândul lor:

extracţia cu solvenţi organiciextracţia pe faza solidăextracţie de fluide supercritice.

7. Metode de Analiză a AntioxidanţilorMetodele de analiză a antioxidanţilor sunt multiple. Cele mai importante metode de analiză a antioxidanţilor [14]:

Metode SpectofotometriceMetode ElectrochimiceMetode Cromatografice Cromatografie de Gaze (GC)Chromatografie pe Strat Subţire (TLC)

Chromatografie de Înaltă Performanţă (HPLC).

Ulterior s-au dezvoltat metode noi de analiză, cum ar fi cromatografia cu solide supercritice [16], [17], [18] sau cromatografia micelară electrocinetică [19], [20], [21], [22].

8. ConcluziiAntioxidanţii sunt substanţe, care sunt adăugate în produse cosmetice sau alimente pentru pentru a intarsia procesul de degradare oxidativă- respective râncezirea acestor produse.Astăzi sunt utilizate mai mult de 15 substanţe chimice ca şi antioxidanţi, cu aplicabilitate stabilită prin reguli normative.După natura lor, antoioxidanţi sunt clasificaţ în: antioxidanţi naturali şi sintetici. Antioxidanţii naturali, în special tocferolii (α-,β-,γ-,δ-tocoferoli), sunt recunoscuţ pentru aplicabilitatea largă a acestora (pentru caracterul antioxidant al acestora, antioxidanţii fiind forme ale vitaminei E).Privind analiza acestor compuşi, aceştia trebuie separaţ dintâi de matricea în care se află, prin: extracţia cu solvenţi organici, extracţia pe faza solidă sau extracţie de fluide supercritice.Metodele de analiză a antioxidanţilor sunt multiple: Metode Spectofotometrice Metode Electrochimice Metode Cromatografice Cromatografie de Gaze (GC) Chromatografie pe Strat Subţire (TLC) Chromatografie de Înaltă Performanţă (HPLC).Ulterior s-au dezvoltat metode noi de analiză, cum ar fi cromatografia cu solide supercritice sau cromatografia micelară electrocinetică.

Bibliografie1. Lupo M. P., Antioxidants and Vitamins in Cosmetics, Clinics in Dermatology, 2001, 19, 467-473. 2. Directiva 95/2 a Comunităţii Europene (Anexa II partea C. din 20.02.1995).3. www.anpc.ro/sec/legislatie/htm.4. Schlossman M. L., The Chemistry and Manufactures of Cosmetics, Allured Publishing Corporation, 2000, 9.5. Boehm M., Williams J., J. Pharm., 232, 1943, 292.6. Hoffmann- LaRoche Catalogue, Roche Products for Human Use, Regional Organization for Vitamins and Chemical Human Nutrition and Health, Vitamins and Fine Chemical Division, Wien, 2005/ 2006, 113. 7. Barel A. O., Paye M., Maibach H. I., Handbook of Cosmetic Science and Technology, M. Dekker Inc., N.Y, 2001, 134. 8. Frankel E. N., Natural and Biological Antioxidants in Food and Biological Systems.Their Mechanism of Action, Applications and Implications, Lipid Technol.,7, 1995, 77-80. 9. Porter N. A., Caldwell S. E., Mills K. A., Mechanisms of Free Radical Oxidation of Unsturated Lipids, Lipids, 30, 1995, 277-290.10. Yanishlieva- Maslorova V., Inhibiting Oxidation, In: Antioxidants in Food Practical Applications, Woodhead Publishing Ltd., Cambridge, 2001, 22.11. Machlin J., Handbook of Vitamins, M. Dekker, N.Y, 1991, 99.12. Packer L., J. Nutr., 131, 2001, 369-373.13. Morton L. W. et al., Biochem. J., 364, 2002, 625.14. Ruperez F. J., Martin D., Herrera E., Barbas C., J. Chromatogr. A., 935, 2001, 45-69.15. Cuvelier C., Dotreppe O., Istasse L., Ann. Med. Vet., 147, 2003, 315-324.16. Ryynanen M., Lampi A. M., Salo- Vaananen P., Ollilainen V., Food Comp. Anal., 17, 2004, 749-765.17. Carlucci G., Mazzeo P., J. Chromatogr. A, 935, 2001, 87-91.18. Yiang C., Ren Q., Wu P., J. Chromatogr A, 1005, 2003, 155-164.19. Lesslier E., J. Chromatogr A, 936, 2001, 201-214.20. Boyce M. C., J. Chromatogr A, 847, 1999, 369-375.21. GuanY ., Chu Q., Fu L., Wu T.,Y e J., Food Chem., 94, 2006, 157-162.22. Frias J., Miranda M. L., Doblado R., Food Chem., 92, 2005, 211-220.23. Spencer B. J., Purdy W. C., J. Chromatogr A, 782, 1997, 227-235.

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Antioxidants in Cosmetics Dipl. Chem. Juncan A. M. Prof. Dr. Hodiş an T.

Cosmetics are commercially available products that are used to improve the appearance of the skin. Lately, consumer demand for more effective products that more substantively beautify the appearance has resulted in increased basic science research and product development in the cosmetics industry. The result has been more ingredients that may actually improve not just the appearance of the skin, but the health of the skin as well. We now have products that renew, restore, and rejuvenate, not just cleanse, protect, and moisturize [1]. There is probably no greater focus of interest currently than the incorporation of vitamins and antioxidants in skin care products.

1. Definition of AntioxidantsAccording to the Directive 95/2/EC from 20.02.1995 [1]- Antioxidants are substances, which prolong the maintenance period of products, trough their protection of deterioration, caused by oxidation (rancidity orcolour modification).To omit translation mistakes of name substances that are used as cosmetic and food antioxidants and for the facility of the label inscription of cosmetic or food packing, the Alimentarius Codex Comission adopted for international use, the International Numbering System of Food Aditives, using the same numbering as the Economic European Union (EEC) [2].In Europe the number of the antioxidizing substances is preceded of the letter E, and the use of a Codex E of the EEC indicates that the substance: - is a antioxidizing substance, the first number indicating the nature of the antioxidizing compound- it was tested on animals and it has been proved that it is safe for consumption - it was registrated as an antioxidizing substance at the speciality forum.

Table 1: Compounds used as Cosmetic and Food Antioxidants

2. Classification of AntioxidantsAntioxidants fall into two classes, namely:a).after their nature, antioxidants are classified in: - natural antioxidants - synthetic antioxidantsb).after their principal function: - proper antioxidants - substances that have antioxidant action, but also present other functions [3].

3.Choice of Antioxidants in CosmeticsSubstances for the prevention of rancidity have been utilized since 1843, of Deschamps.An antioxidant should possess certain physical and physiological properties if it is to be of practical value in cosmetic, pharmaceutical and food preparation:*it should be nearly neutral in reaction;* it should be easily and definitely soluble in the substrate;* it must be pharmacologically safe and must not be strongly toxic to animal tissues [4].Whilst the above criteria apply to pharmaceutical and food products they may equally well be applied to cosmetic preparations, with the addition that the antioxidant must be dermatologically innocuous: free from primary irritating effects and from sensitizing properties; since the skin is often more sensitive to affront than is, for example, the stomach and in the case of lipsticks in particular, great care should be taken in choosing a suitable antioxidant material.The use of antioxidants in cosmetics can be made even indivodual or as a mixture of antioxidants, when the antioxidant power increases.

4. Cosmetic Application: Concepts and RecipesVitamins A (Retinyl Palmitate), C (Ascorbic Acid) and E (Tocopherol or Tocopheryl Acetate) are the most popular antioxidants in skincare [5].In skin care, and especially in sun care products Tocopherol and Tocopheryl Acetate are important due to the following properties:smoothens the skin prevents premature aging of skin by blocking lipid peroxidation responsible for cell membrane damage tissuesreduces UV induced damage to cells and tissues anti-inflamatory properties inhibits erythema formation caused by UV irridiation, especially after repeated application.

5. Mechanism of Action and Function of Tocopherols as AntioxidantsCosmetic preparations containing fats and oils, particularly those characterized by a high incidence of unsaturated linkages, are susceptible to oxidative deterioration. Peroxide value is one of the most important criteria used to monitor the oxidation process. In the course of oxidation, the peroxide value first increases very slowly (the induction period). When this period ends, the peroxide value starts growing very rapidly, and signs of deterioration become evident [6]. The efficacy of antioxidants can be expressed as a protective factor (PF):

Figure 1: Classification of Cosmetics and Food Antioxidants

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When considering the inhibition of lipid oxidation, antioxidants are:- chain-breaking, substances inhibiting the propagation step/they interrupt the autoxidation chains and- preventive antioxidants [7], [8], [9].

Figure 2: Steps in the Production of Cosmetics

5.1 Factors affecting RancidityAntioxidants are influenced by certain internal and external environmental factors, which may either contribute to the destruction of the antioxidant effect or enhance it in protecting against rancidity [3]..» temperature conditions» presence of - moisture -light -oxygen5.2 Antioxidant Activity of Tocopherols The anti-oxidant activity of Vitamin E is based on the ease with which the hydrogen on the hydroxyl group of the chroman ring can be donated to neutralize a free radical (creating a more stabile tocopheroxyl radical) [10], [11], [12].

Figure 4: Scale ofi Antioxidant Activity of Tocopherols

Figure 3: Mechanism of Action of Tocopherols

6. Extraction Methods of Antioxidants The most important step in a chemical analysis is the extraction step. to analyse this compounds it is necessary to separate them from the cosmetic matrix [13], [14], [15]. There are two majore approaches to extract the antioxidants from the matrix:- direct extraction of the antioxidants without fat saponification- extraction of the antioxidants after fat saponificationThis two methods utilises: - extraction with organic solvents - solid phase extraction - supercritical fluid extraction

7. Analysis Methods of AntioxidantsThe analysis methods of antioxidants are multiple. The most important analysis methods of antioxidants used in cosmetics are [14]:

- Spectophotometric Methods- Electrochemical Methods

- Chromatographic Methods Gas Chromatography (GC)-Thin Layer Chromatography (TLC) -High Performance Liquid Chromatography (HPLC).

Presently new chromatographic methods were developed, like supercritical fluid chromatography [16], [17], [18], or micellar electrokinetic chromatography [19], [20], [21], [22].

8. ConclusionsAntioxidants are substances, that are added in cosmetic and food products to retard the oxidative degradation processes- rancidity, of those products.Today there are used more than 15 chemical substances as antioxidants, with an applicability established trough normative acts.After their nature, antioxidants are classified in natural and synthetic antioxidants. Natural antioxidants, specially the tocopherols (α-,β-,γ-,δ-tocopherols) are recognized for their large application (by the reason of their antioxidative character and those one of vitamin- tocopherols are forms of vitamin E).For the analysis of these compounds, they have to be first separated from their matrix, trough: extraction with organic solvents, solid phase extraction, supercritical fluid extraction.The analysis methods of antioxidants are multiple: ? spectrophotometrical methods ? electrochemical methods ? chromatographic methods Gas Chromatography (GC),Thin Layer Chromatography (TLC),High Performance Liquid Chromatography (HPLC).

Presently new Chromatographic methods were developed, like supercritica fluid chromatography, or micellar electrokinetic chromatography.

References1. Lupo M. P., Antioxidants and Vitamins in Cosmetics, Clinics in Dermatology, 2001, 19, 467-473. 2. Directiva 95/2 a Comunităţii Europene (Anexa II partea C. din 20.02.1995).3. www.anpc.ro/sec/legislatie/htm.4. Schlossman M. L., The Chemistry and Manufactures of Cosmetics, Allured Publishing Corporation, 2000, 9.5. Boehm M., Williams J., J. Pharm., 232, 1943, 292.6. Hoffmann- LaRoche Catalogue, Roche Products for Human Use, Regional Organization for Vitamins and Chemical Human Nutrition and Health, Vitamins and Fine Chemical Division, Wien, 2005/ 2006, 113. 7. Barel A. O., Paye M., Maibach H. I., Handbook of Cosmetic Science and Technology, M. Dekker Inc., N.Y, 2001, 134. 8. Frankel E. N., Natural and Biological Antioxidants in Food and Biological Systems.Their Mechanism of Action, Applications and Implications, Lipid Technol.,7, 1995, 77-80. 9. Porter N. A., Caldwell S. E., Mills K. A., Mechanisms of Free Radical Oxidation of Unsturated Lipids, Lipids, 30, 1995, 277-290.10. Yanishlieva- Maslorova V., Inhibiting Oxidation, In: Antioxidants in Food Practical Applications, Woodhead Publishing Ltd., Cambridge, 2001, 22.11. Machlin J., Handbook of Vitamins, M. Dekker, N.Y, 1991, 99.12. Packer L., J. Nutr., 131, 2001, 369-373.13. Morton L. W. et al., Biochem. J., 364, 2002, 625.14. Ruperez F. J., Martin D., Herrera E., Barbas C., J. Chromatogr. A., 935, 2001, 45-69.15. Cuvelier C., Dotreppe O., Istasse L., Ann. Med. Vet., 147, 2003, 315-324.16. Ryynanen M., Lampi A. M., Salo- Vaananen P., Ollilainen V., Food Comp. Anal., 17, 2004, 749-765.17. Carlucci G., Mazzeo P., J. Chromatogr. A, 935, 2001, 87-91.18. Yiang C., Ren Q., Wu P., J. Chromatogr A, 1005, 2003, 155-164.19. Lesslier E., J. Chromatogr A, 936, 2001, 201-214.20. Boyce M. C., J. Chromatogr A, 847, 1999, 369-375.21. GuanY ., Chu Q., Fu L., Wu T.,Y e J., Food Chem., 94, 2006, 157-162.22. Frias J., Miranda M. L., Doblado R., Food Chem., 92, 2005, 211-220.23. Spencer B. J., Purdy W. C., J. Chromatogr A, 782, 1997, 227-235.





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Demodecidoza

Dr. Anca Zbranca,Dr. Claudia Artenie ,Dr. Mirela Cherciu

Demodex folliculorum causes a rosacea-like disorders in humans. Demodicidosis is a cronic infestation, more common in elderly patients. Clinical, there are typically follicular papules and pustules, especially on the cheeks.Unilateral distribution is for Demodex folliculorum and against rosacea. There may be pruritus and a fine scale. Sometimes are also be involved the eyelids( Demodex blepharitis). Usaully rosacea and demodex infestation come together .At these patients lesions are bilateral. For treatment, we can tried standard antiscabetic, such as lindane, crotamiton or permethrin. The permethrins are the least irritating topical treatment for the eyelid problems. Demodex folliculitis is now felt to be a separate disease. Demodex folliculorum determina la om o afectiune asemanatoare rosaceei . Demodecidoza este o infestatie cronica, mai frecventa la pacientii varstnici. Clinic, se descriu papule foliculare tipice si pustule, mai ales pe obraji. Distributia unilaterala a leziunilor pledeaza pentru Demodex folliculorum, si nu pentru rosacee.Leziunile pot fi pruriginoase si acoperite de o scuama subtire.Uneori pot fi atinse sprancenele( blefarita cu Demodex). De obicei, rosaceea si infestatia cu demodex apar impreuna. La acesti pacienti lesiunile sunt bilaterale. Pentru tratament putem incerca antiscabicidele obisnuite , cum ar fi lindan, crotamiton sau permetrina. Permetrinele sunt putin iritante in tratamentul topic al leziunilor oculare. Foliculita cu demodex este considerata astazi o afectiune de sine statatoare.

Care este valoarea terapeuticã a celulelor stem?

În prezent, celulele stem sunt folosite în tratamente specifice unor afecţiuni cum sunt leucemia, cancerul şi afectiuni autoimune. Oamenii de stiinţa apreciazã cã aceste celule stem vor avea un rol determinant în tratamentele viitoare şi vor fi aplicate multor alte afecţiuni. Celulele stem pot regenera mai multe tipuri de ţesut (exemplu: al ficatului, al cordului), nervi, sânge. Odatã detectatã afecţiunea tratamentul cu celule stem duce la refacerea celulelor afectate. Exemplu: Dupã un infarct miocardic, transplantul de celule stem are un efect pozitiv în procesul de vindecare. Celulele stem implantate, se transformã în celule musculare pentru a înlocui ţesutul muscular afectat, îmbunãtãţind astfel funcţionarea inimii. Conform Cord Blood Donor Foundation USA mai mult de 50 de afecţiuni pot fi tratate cu ajutorul celulelor stem, printre acestea fiind Leucemia (limfocitarã, mieloidã), Anemia Aplasticã, Neuroblastoma, Boala Hodgkin, Cancerul (ovar, sân, testicule), Artrita, Scleroza, Lupusul. Pe viitor, pe baza studiilor efectuate se vor aborda t ratamente pentru afec ţ iuni ca Alzheimer, Diabet, Parkinson, Distrofie Muscularã. Multe dintre aplicaţiile celulelor stem în stiinţa medicalã se aflã încã în stadiu experimental, dar nu va mai trece mult timp pânã când vor reprezenta o terapie de rutinã. Un lucru este cert, recoltarea sângelui din cordonul ombilical poate avea loc doar o singura datã, la naştere!

Cryo-Save





Dermal Fillers Training Workshop for Facial Aestheticss

Dr. FS Butt, Consultant Plastic Surgeon

This workshop will have four parts

1. Comprehensive Didactic Presentation2. Question and Answer session3. Practical Live demonstration4. Self assessment MCQ and results

In this TWO HOURS intensive training workshop, comprehensive didactic presentation will be given on the history, background, and development and characteristics of dermal fillers. Dr. Butt will discuss the consultation and assessment process, implement patient selection criteria and explore the importance of establishing realistic patient expectations and proper patient education to ensure positive patient outcome. Comprehensive didactic will be presented of the different injection techniques, contraindications and precautions, potential risks and safety issues, as well as management and treatment of complications. Pain management issues including topical numbing agent. Intense practical sessions will highlight the day. Dr. Butt will explore the creative and artistic aspects important for a successful treatment outcome which will include special techniques to create the look your patients' desire and ways to treat difficult problem areas. This workshop will focus on the development of dermal fillers, techniques, patient selection, patient expectations and proper injection techniques for cosmetic procedures. We will explore the creative and artistic aspects important for a successful treatment outcome.

Objectives:1. Describe the differences between Collagen and Hyaluronic Acids for skin 2. Assess the proper application of soft tissue augmentations 3. Describe the patient consultation4. Describe the Patient evaluation 5. Describe the patient selection criteria 6. Proper Medical history taking for specific Patients7. Standardized procedures & protocols8. Describe pain management issues, use of topical numbing agents.9. Discuss and Demonstrate proper preparation and injection techniques10. Discuss indications, contraindications, precautions, and potential risks11. Demonstrate proper management and treatment of complications12. Summarize adverse events

BOTOX Training Workshop for Facial Aesthetics and hyperhidrosis

Dr. FS Butt, Consultant Plastic Surgeon

This workshop will of four parts

1. Comprehensive Didactic Presentation2. Question and Answer Session3. Practical Live Demonstrations4. Self Assessment MCQs

This workshop will be intensive and designed to teach the use of botulinum toxin for facial enhancement as well as hyperhidrosis. The comprehensive didactic presentation will covers the theory and practice of botulinum toxin. The practical session is reserved for workshop demonstrations and training of participants.Dr Butt will explain the applications of Botox® for cosmetic purposes with a focus on the most popular areas requested for treatment. Presentation will include an introduction to history and new developments on the horizon of botulinum toxin. Significant focus on pertinent facial anatomy and physiology will be presented which is the cornerstone to safe and effective treatment. You will receive a comprehensive presentation of the mechanism of action, contraindications, safety and efficacy issues, management and treatment of complications, and storage, preparation, and dilution guidelines. Practical session will include identifying and mapping areas for injection and actually doing the injections.

Learning Objectives: Participant will be able to:1. Identify pertinent facial anatomy2. Understand underlying muscle structure3. Explain physiology (direction of muscle movement) muscles4. Learn what kind of wrinkles can be improved by Botox.5. Know the difference between hyperfunctional, dynamic and static wrinkles.6. Understand Botox storage, reconstitution and injection techniques.7. Explain mechanism of action8. Understand when Botox may not be indicated9. Discuss safety issues of administration10. Plan safe storage, preparation, and proper dilution11. Demonstrate proper technique for injection12. Demonstrate proper management and treatment of complications





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