Abstracts

Safe Aging Management with Hormones in Men
Men with hormonal changes may experience moodiness, memory loss, lack of energy, decline in sex drive, physical strength, endurance, decrease of lean muscle mass and bone mineral density in the spine. My presentation focuses on my clinical practice of bio-identical hormonal therapy for men to counteract these changes and improve their quality of life.

How l manage my anti-aging consultation
The purpose of my presentation is to show the Brazilian peculiarities in the evaluation of patients seeking advice for aging well. As in all countries, we give great importance to the hormonal balance, so it is essential to evaluate thyroid function, adrenal, testicular, ovarian and pituitary especially with regard to GH. In Brazil there is a close relationship between ...
anti-aging and orthomolecular therapy that is nothing more than biochemistry applied to medicine. Therefore, systematically, we do evaluate the levels of vitamins A, E, C, D, E, B2 and B12, as well as beta carotene, lycopene, coenzyme Q10 and antioxidant enzymes (SOD, catalase and glutathione peroxidase) in order to know if there is need for supplementation and do it in a individualized way. We also evaluate the levels of zinc, copper, selenium and manganese for their importance in general and particularly because they are essential cofactors for antioxidant enzymes. You can not separate the orthomolecular from nutrition, so this is the third point of support in our strategy, we do a nutritional assessment and advise the patient according to their most pressing needs, overweight, dyslipidemia, metabolic syndrome, dysbiosis, etc. We routinely evaluate metabolic syndrome as a whole (glucose, insulin, lipids, uric acid) and diseases associated with it like heart disease and atherosclerosis Lp(a), homocysteine, CRP, fibrinogen). We cannot let go of physical activity, sleep, preventive tests, but the list would become endless and it is our practice to go and evaluate the patient gradually, initially focusing on the most obvious problems. It is clear that there is a general treatment, but virtually all our patients receive nutritional guidance and individualized supplementation of vitamins, minerals and amino acids, when necessary, and almost always it is. There is a wide acceptance of hormone replacement as a whole in Brazil, of course in an individualized manner and discussed with patients. We can say that 80% of anti-aging in Brazil is done through nutrition, orthomolecular, hormonal balance and orientation for physical activity. Most patients have a good idea of what to expect of the proposed anti-aging strategy, although some have exaggerated expectations and need to be brought to reality. This is because of this whole scheme, all this prevention and treatment is still expensive and hits only to the most favored ones, culturally and economically, consequently the better informed are the ones who seek our help. In our country it is impossible to separate Anti-aging from Aesthetic Medicine, because our people demand the expectation of aging well, having a healthy longevity, but also maintaining a good appearance and shape.

Potential of Plasma Rich in Growth Factors (PRGF) for in situ regenerative medicine: progress in anti-aging medicine

Plasma rich in growth factor (PRGF) technology involves the use of patient’s own biologically active proteins, growth factors and biomaterial scaffolds for therapeutic purposes. This technology provides a new approach for the stimulation and acceleration of healing and tissue regeneration. The versatility and biocompatibility of using patient-derived fibrin scaffold as an autologous, biocompatible and biodegradable drug delivery system opens the door to a personalized medicine that is currently being used in numerous medical and scientific fields including dentistry, oral implantology, orthopaedics, ulcer treatment, and skin regeneration among others. The present conference discusses the state of the art and new directions in the use of this endogenous technology in anti-aging ...medicine.

EFFFECTS OF AIR POLLUTION AND CLIMATE CHANGES ON PULMONARY FUNCTION AND RESPIRATORY DISEASES

Respiratory diseases mortality and morbidity shows an increasing tendency in every countries, namely in areas such as asthma, rhino - sinusitis, chronic obstructive pulmonary disease (COPD), respiratory tract infections and lung cancer. There are a lot of evidence that indoor and outdoor air quality are implicated in the situation.
Recent investigations results indicate that the present current levels of air pollution associated to nitrogen dioxide, acid vapour, particulate matter < 2,5 μm and CO, have chronic adverse effects on lung development in children, leading to clinically significant deficits in FEV1 when children reach adulthood.
Numerous studies, such as those conducted by scientists of the National Institute of Environmental Health Sciences (USA) has shown that long – term ...exposure to air pollutants increases the risk of respiratory illness such as allergies, including asthma, COPD and lung cancer. Children and elderly are particularly vulnerable to the health effects of ozone, fine particles and other airborne pollutants.
Recent investigations suggests that the exposure to pollutants derived from the domestic use of fossil fuel and biomass may hinder lung development and limit breathing capacity for lifetime. These pollutants are the fourth leading cause of morbidity and mortality in developing world, particularly due to acute respiratory infections in children and COPD in non- smoking women.
Other studies indicate that increases in ground level ozone, primary component of urban smog, may actually cause asthma. In older adults exposure to high concentrations of nitrogen dioxide and PM 2,5 μm are associated with increased rates of hospitalization for community – acquired pneumonia. Other studies support the idea that exposition to ozone and O2 pollution are associated with increased incidence of pneumonia and flue.
Climate changes affect respiratory health through: increased number of deaths and acute morbidity due to heat waves, increased frequency of respiratory events due to higher concentration of ground level ozone, changes in the frequency of respiratory diseases due to trans boundary air pollution (e.g. related to fires and aerosols), altered spatial and temporal distribution of allergens. These impacts will not only affect those with respiratory diseases but also may influence the incidence and prevalence of respiratory diseases in an exposed population.
In conclusion the indoor and outdoor air quality clearly interfere with the lung development and the incidence and prevalence of respiratory diseases. Climate changes significantly contribute to air quality and are related with the effects of air pollution in human health. A commitment to new air quality standards with the objective of achieve a cleaner air world will prevent millions of premature deaths and achieve an important diminishing of incidence and prevalence of respiratory diseases.

Hormones are cellular messengers, conducting multiple roles in the maintenance of quality of life. From the 40 years onwards, human beings, in general, present a progressive decrease in synthesis and action of the sex hormones, precipitating morphological and functional changes that will eventually lead to the consolidation of greater deposition of central fat, favoring risk of obesity, diabetes and cardiovascular disease. A discussion, based on my clinical practice, will be provided on the prevention of the metabolic syndrome through the use of bio-identical hormones.

The biological aging can be defined as the progressive loss of optimal body functions as a result of intrinsic factors .This decline continues until the end of life. Although there are several hypotheses that attempt to explain the causes of aging, only a few are widely accepted, which does not mean they are correct. Among them, the theory of Harman , is 50 years-old and it is continuously revised revised . Thi theory postulates that the macromolecular damage induced by reactive oxygen species (ERO) is the main causal factor of aging and related diseases. These ERO are formed during the normal metabolism, primarily in detoxification reactions mediated by the microsomal cytochrome P-450 and in the electrons chain within the mitochondria. In addition, there are several exogenous sources of oxidative stress. In order to control the aging process, both sources of oxidants must be minimized. A few strategies to ...reach this goal will be presented.

Abdominoplasty : my technique and work

The abdomen is one of the body region that more suffer variation with the genetic, age, body weight variation and pregnancy. The techniques described in the literature since 1890, present dozens of new procedures and refinements that are introduced until now. Basically, the aesthetic result’s quality changed significantly when compared with ancient procedures, being unacceptable today by our patients. Four basic techniques are more used by the doctors and requested by the patients. 1…. Low transversal pubic incision . It is more current , based on the high aesthetic result’s quality and by the anatomical position of the scar that remain hidden by a small bikini. 2… Mini-abdominoplasty, has more selective indication, restricted to moderate abdominal aesthetic problems with or without umbilicus mobilization. 3… Fleur-de-lis type of ...incision that leaves an inverted T shape scar placed along the xiphoid-pubic line combined with another transversal low pubic scar. It has even more restricted indication. It is mainly used in the patients after bariatric surgeries and those with protruded abdomen. Finally 4… Reverse abdominoplasty , is even more restricted to reduce protruded epigastrium , without touching the navel nor the normal hypogastrium. This surgery, may also be combined with breast surgery in the same stage was introduced by us in the literature in 1979. Finally another technical detail also introduced by us in 1994 called “kilting suture” is routinely used not only in the abdominoplasty but in every situation to avoid hematoma and seroma to reduce the dead space. Pre, trans e long term pos-operative cases illustrate each type of procedures.

External ultrasound-assisted liposuction (XUAL)

Stella Obasanjo the First Lady of Nigeria from 1999 until her death in 2005, died a few weeks before her 60th birthday from complications of liposuction at a private health clinic in Puerto Banús, Marbella, Spain, on 23 October 2005. The surgeon, identified only as “AM“ in court, was sentenced to one year of imprisonment in September 2009 on a charge of “causing homicidethrough negligence“, disqualified from medicine for a period of three years and ordered to pay€120,000 (approximately US$176,000) in compensation to Stella Obasanjo`s son.
The physician had misplaced a tube designed for a liposuction procedure into Obasanjo`s abdominal cavity. She sustained a punctured colon and lacerated liver and died two days after the surgery.
Often used in conjunction with other plastic surgery techniques, liposuction ...removes pockets of fat from troublesome areas such as the thighs, hips, abdomen, and upper arms. Liposuction procedures vary depending on what your ultimate cosmetic goal is, and whether you are combining liposuction with other plastic surgery procedures.Simply put, liposuction is the surgical removal of fat cells through a stainless steel suction tube called a cannula. Like any plastic surgery, liposuction carries some amount of risk. Although liposuction complications are rare, they can include infection, nerve damage, seizures, and negative reactions to anesthesia. The most effective way to minimize your risk is to have a thorough physical examination prior to liposuction surgery. There is also the risk of experiencing adverse side effects, such as bruising and scarring.
To avoid this kind of problems we are actually doing  XUAL (External ultrasound-assisted liposuction). XUAL is a type of UAL (Ultrasound-assisted liposuction ) where the ultrasonic energy is applied from outside the body, through the skin, making the specialized cannula of the standard UAL procedure unnecessary. It was developed because surgeons found that in some cases, the UAL method caused skin necrosis (death) and seromas, which are pockets of a pale yellowish fluid from the body, analogous to hematomas (pockets of red blood cells).XUAL is a possible way to avoid such complications by having the ultrasound applied externally. It can also potentially cause less discomfort for the patient, both during the procedure and afterwards; decrease blood loss; allow better access through scar tissue; and treat larger areas. We are actually using a machine that combines XUAL with Radio Frequency, with a technology designed exclusively for cosmetic use.The heat produced by the system causes instant tightening of collagen and increases collagen production in the dermis.The treatment is ideal for face and neck remodelling, tightening and lifting flaccid areas of the face, reduce wrinkles, increase luminosity of the skin, body remodelling and cellulites, tightening areas of loose skin on the body, cellulite on arms, thighs, abdomen and bottocks. All this procedure can be seen in the 9 minutes video I will show today.

A capacidade de regeneração cutâneo do nosso organismo através dos mecanismos homeostáticos, é utilizada através da utilização dos factores de crescimento epiteliais potenciada pela capacidade de indução de colágenio que a técnica de micro agulhas permite. A terapia com Plasma Rico em Plaquetas aplicada com micro agulhas no conceito RIMA, permite-nos ter uma técnica minimamente invasiva no tratamento de flacidez, rugas, estrias, alopécia melasma, em qualquer zona do corpo, qualquer tipo de pele e em qualquer época do ano.

FINESS IN BLEPHAROPLASTY 

World Health Organization establishes as a health concept the complete physical, mental and social well-being.

The association of Oculoplastics & Aesthetical Medicine carries out a medicine program of preventive, healing and facial rehabilitation.

In that context, the oculoplastics’ surgeon assumes ocular aesthetics health both with responsibility and quality, under the scientific, ethic, and legal veil, which must guide its performance.

Among the most performed and beautiful surgeries in Oculoplastics, the Blepharoplasty is pointed out. That cosmetic eyelid surgery usually lasts for 1 to 2 hours, and is carried out with local anesthesia and sedation.

Neglected diseases and environmental changes - the cholera pandemic

Cholera is an emergent disease caused by a motile bacterium – Vibrio cholerae, commonly found in brackish and coastal waters as well as in freshwater. Zooplankton, fish, shellfish and aquatic plants are natural reservoirs. Once ingested by humans in appropriate amounts, may find a suitable habitat in the intestinal tract. The disease is expressed if toxins are released by strains that contain specific coded genes. The ongoing 7th epidemics started in 1961 in Asia and spread to India, Europe, Africa and Latin America. The current climate changes may exacerbate the occurrence locally. In sub-Saharan Africa, the first cases were reported in early 70’s. Cholera quickly spread throughout the continent due to inadequate infrastructures and limited access to health care that led to high death rates. Almost 40 years later, cholera ...still remains a burden mainly for African countries (93% of the cases in 2008), which cannot afford to establish or to maintain necessary hygienic and medical facilities. In Guinea-Bissau (West Africa), cholera epidemics are recurrent. The latest epidemic (2008), started with the onset of the wet season, infected 14,324 people and 254 died, most of them in hospitals. Most of the 1.6 million inhabitants retrieve water for their daily needs from shallow wells located at walking distance from their homes, and close to latrines. Local authorities have been reactive rather than proactive in what water resources are concerned, and no comprehensive knowledge of the well water quality is, officially, available although our research indicates that 80-100% of the wells are fecally contaminated throughout the country.

Tissue content of hydroxyestrogens in relation to survival of breast cancer patients

Giuseppe Carruba1, Orazia M. Granata1, Adele Traina2, Barbara Ravazzolo3,
4Biagio Agostara, and 1Luigi A.M. Castagnetta

1Experimental Oncology, 2Breast Cancer Registry, and 4Clinical Oncology, Department of Oncology, ARNAS-Civico, Palermo, Italy. 3Department of Public Health, Epidemiology and Preventive Medicine, A.S.L. 6, Palermo, Italy.

The main goal of our study was to assess hydroxyestrogen contents in breast tumor tissues, having different estrogen receptor (ER) status, in relation to long-term follow-up of patients.
Twenty-one breast cancer cases, all collected from January 1986 up to January 1988 at the M. Ascoli Cancer Hospital Center in Palermo, were included in the study. Average follow-up time was 144±10 months. The ER status of tissues was determined by both ...ligand binding and immunohistochemical assays. A high performance liquid chromatography (HPLC)-based approach, jointly with gas chromatography/mass spectrometry, was used to identify and measure various hydroxyestrogens and their methoxy derivatives in tumor tissues.
Variable concentrations of hydroxylated estrogens were detected. No statistically significant association was found between intratumor levels of any measurable hydroxyestrogen and tumor volume, grading, nodal status or other potentially confounding variables (including medical treatment). A significant positive association was observed with 16αOHE1 (P=0.015), leading to significantly lower (P=0.043) 2OHE1:16αOHE1 ratio values in patients alive. Conversely, ratio values of 4- to 2-hydroxy+methoxy (4:2OH+MeO) estrogens was significantly lower (P=0.006) in deceased patients. Using cut-off values of 1.2 for 4:2OH+MeO ratio and 150 fmol/mg tissue for 16αOHE1 we achieved a clear-cut separation of patients, with over-cut off patients having 147 months, and under cut-off patients showing only 47 months median survival time (P=0.00008).
Our data imply that individual hydroxyestrogens may have a distinct role in the onset and the clinical progression of breast cancer, with greater 16αOHE1 levels being associated to a prolonged survival of patients.


A traditional Mediterranean diet decreases endogenous estrogens in healthy postmenopausal women

Giuseppe Carruba1*, Orazia M. Granata1, Ildegarda Campisi1,
Biagio Agostara2, Rosanna Cusimano3, Adele Traina4

1Experimental Oncology and 2Clinical Oncology, Department of Oncology, ARNAS-Civico, Palermo, Italy. 3Department of Public Health, Epidemiology and Preventive Medicine, A.S.L. 6, Palermo, Italy. 4Breast Cancer Registry, ARNAS-Civico, Palermo, Italy.
Breast cancer incidence and mortality rates are markedly lower in the south than in the north of Europe. This has been ascribed to differences in lifestyle and, notably, dietary habits across European countries. However, little information exists on the influence of different dietary regimens on estrogens and, hence, on breast cancer risk. Here we report results of our Mediet Project, a randomized, dietary intervention study aimed to assess the effect of a Mediterranean diet on the profiles of endogenous estrogens in healthy postmenopausal women. Out of the 230 women that initially volunteered to participate in the study, 115 were found to be eligible and were enrolled. Women were then randomized into an intervention (n=58) and a control (n=57) group. Women in the intervention group adhered to a traditional, restricted Mediterranean diet for six months, while women in the control group continued to follow their regular diet. Women in the intervention group substantially changed their dietary regimen, and this eventually led to shift from a prevalent intake of animal fat and proteins to a prevalent intake of vegetable fat and proteins. As far as urinary estrogens are concerned, no significant difference was observed between the intervention and control groups at baseline. After six months, however, control women did not show any major change but women in the intervention group exhibited a significant decrease (over 40%) of total estrogen levels (P<0.02). The most part of this modification was based on a marked decrease of specific estrogen metabolites, including hydroxy- and keto- derivatives of estradiol or estrone. Preliminary evidence obtained through the assessment of DNA methylation status in peripheral blood mononuclear cells from both control and intervention women at baseline and after 6 months clearly indicates that dietary changes are responsible for major individual modifications of DNA methylation measured on the promoter region of LINE-1. To our knowledge this is the first report to show that a traditional Mediterranean diet significantly reduces endogenous estrogen and profoundly affect methylation status of DNA. This may eventually lead to identify selected dietary components that more effectively decrease estrogens levels and have a favorable epigenetic impact, thus providing a basis to develop dietary preventive measures for breast cancer.



Estrogen and Prostate Cancer: An Eclipsed Truth in an Androgen-Dominated Scenario

Giuseppe Carruba, MD, PhD

Experimental Oncology, Department of Oncology, ARNAS-Civico, Palermo, Italy

Human prostate cancer is generally considered a paradigm of androgen-dependent tumor; however, estrogen role in both normal and malignant prostate appears to be equally important. The association between plasma androgens and prostate cancer remains contradictory and mostly not compatible with the androgen hypothesis. Similar evidence apply to estrogens, although the ratio of androgen to estrogen in plasma declines with age. Apart from methodological problems, a major issue is to what extent circulating hormones can be considered representative of their intraprostatic levels. Both nontumoral and malignant human prostate tissues and cells are endowed with key enzymes of steroid metabolism, including 17βhydroxysteroid dehydrogenase (17βHSD), 5α-reductase, 3α/3βHSD, and aromatase. A divergent expression and/or activity of these enzymes may eventually lead to a differential prostate accumulation of steroid derivatives having distinct biological activities. Locally produced or metabolically transformed estrogens may differently affect proliferative activity of prostate cancer cells. Aberrant aromatase expression and activity has been reported in prostate tumor tissues and cells, implying that androgen aromatization to estrogens may play a role in prostate carcinogenesis or tumor progression. In animal model systems estrogens, combined with androgens, appear to be required for the malignant transformation of prostate epithelial cells. Although the mechanisms underlying the hormonal induction of prostate cancer in experimental animals remain uncertain, there is however evidence that long term administration of androgens and estrogens results in an estrogenic milieu in rat prostates and in the ensuing development of dysplasia and cancer. Both androgen and estrogen have been reported to stimulate proliferation of cultured prostate cancer cells, primarily through receptor-mediated effects. As for estrogens, the two major receptor types, ERα and ERβ, are both expressed in both normal and diseased human prostate, though with a different cellular localization. Since these two receptors are different in terms of ligand binding, heterodimerization, transactivation, and estrogen response element (ERE) activity, it is likely that an imbalance of their expression may be critical to determine the ultimate estrogen effects on prostate cancer cells. In prostate cancer, ERβ activation appears to limit cell proliferation directly or through ERα inhibition, and its loss has been consistently associated with tumor progression. Several splicing variants of both ERα and ERβ exist. Little is known about their expression and function in the human prostate, although reciprocal regulation and interaction with gene promoter both warrant further investigation. In summary, although multiple consistent evidence suggests that estrogens are critical players in human prostate cancer, their role has been only recently reconsidered, being eclipsed for years by an androgen-dominated interest.

BEYHOND HORMONAL TREATMENTS FOR CLIMACTERIC WOMEN
 
The climacteric woman is an aging woman. As such, our most important objective is to prevent biological aging from exceeding her chronological age,
thus giving her better quality of life to her coming years and  more years to live, free from preventable diseases.
Other than hormonal treatments there are today proven strategies that prevent the shortening of the chromosomal telomeres, the markers of biologic aging.
Special attention must be paid to a good quality of life, exercise to combact sedentarism, a proper nutrition, tabagism abstention, quality of sleep, among many others.

Nutrients for combating stress and fatigue

Over the years the organism looses energy and the capability of regeneration. An accelerated blockage of the regeneration capability, due to several factors as chronic infections, environmental contamination, life style, and food, becomes in a premature aging, with a diminish of the quality of life. Anti aging medicine tries of obtain a lasting maintenance or re-establishing the vitality levels (verified by several age parameters). We talk about the recovery or improvement of the biological functions or about we call Vitality. We use the word vitality thinking about energy, so that the anti aging treatments have the capability of revitalizing and giving energy. With time we are heading to biological entropy, that is, aging and death itself. We understand the entropy as the amount of degraded energy that cannot be used. With the reduction of entropy, a ...decrease of defensive systems appears a decrease of the capability of regeneration. A dietary supplement is the most important in the therapies of anti-aging medicine. The National Academy of Sciences published three studies about the aging effects than can be partially reverted with the combination of L-carnitine and lipoid acid (Hagen et al, 2002), One of these studies inform us that the supplementation of these two nutrients provokes a partial improvement in the function decline of the mitochondrial membrane although the oxygen consumption was increasing. Lipoid acid with acetil-L-carnitina improves the walking activity. Aged human are characterized by lethargy, weakness and diseases and the supply of these nutrients gives antiaging measurable effects. To obtain a good result, we must know the biological-biochemical status of the patient, to understand his meaning, to correct habits, way of life and to supply the appropriated nutrients with antioxidant, regenerated and energizer capabilities. Among the different therapies used in antiaging medicine, it is founded the energy therapies based on supplements as coenzyme Q10, carnitine, B complex, D Ribose, ATP, piruvate A. Therapies that we will talk about them in my presentation.

Laser in Dermatology

The author will be focused on a wide variety of Laser used in Dermatology, either for treatment or esthetic proposes. Resurfacing, Subresurfacing, Fractional Resurfacing and Laser for treatment of vascular and pigmentation disorders will be approached. Through the presentation, the author will expose some of her personal experience alongside with clinical cases

Impact of Menopause on Female Urology

The pelvic organ prolapse are one of the body region that suffer variation with the age, body weight, intestinal transit and pregnancy. Today we wave technics that permit a correct diagnosis and treatment of the pelvic defects such as mini slings, meshs and laparoscopic technics. The purpose of my presentation is to show how to diagnose and treate such problems, that are related with the aging.

Nutrigenomics and Personalized Nutrition – Science and Concept

Nutritional Genomics studies the interaction of food and its components with the human genome, in a molecular, cellular, and systemic level. Its main objective is to use diet, for preventing or treating disease.
In the nutritional genomics there are two terms used: Nutrigenetics, and Nutrigenomics.
Nutrigenetics studies the effect of the genetic variation, in the interaction within diet and disease. This includes the identification and characterization, of the genetic variants associated to different responses to nutrients. Its main objective is to make recommendations concerning the risks and benefits of specific diets, or isolated dietetic components. It is also called personalized or individualized nutrition.
The potential benefits of harnessing the power of genomics for dietary prevention ...of disease are enormous, and this is the approach being considered for the future of nutrition research in the posgenomic era.
The genomics revolution has catapulted development of various new technologies that can be applied to nutritional science.
The techniques, genomics, proteomics, metabolomics and bioinformatics are beginning to stand out to facilitate the study of gene-nutrient interactions at cellular, personal and in the population.
Nutrigenomics is the study of the effects of foods and food constituents on gene expression, and studies the effect of nutrients over the genoma, proteoma, and metaboloma.
Nutrigenomics is about how our DNA is transcribed into mRNA and then to proteins and provides a basis for understanding the biological activity of food components. Nutrigenomics has also been described by the influence of genetic variation on nutrition by correlating gene expression or single-nucleotide polymorphisms with a nutrient`s absorption, metabolism, elimination or biological effects. By doing so, Nutrigenomics aims to develop rational means to optimize nutrition, with respect to the subject`s genotype. By determining the mechanism of the effects of nutrients or the effects of a nutritional regime, Nutrigenomics tries to define the causality -relationship between these specific nutrients and specific nutrient regimes (diets) on human health.
Nutrigenomics has been associated with the idea of personalized nutrition based on genotype, and so act in an innovative preventive pathway through nutrition.

Bone regeneration and its impact in Anti-aging

Bone plays a key role in the support of Face soft tissues. Therefore bone loss in the face, mostly due to loss of teeth, represents a major factor of premature aging. Bone grafts were for a long time the unique reliable option to substitute atrophic or absent bone. For the past decade the industries investment in developing Biomaterials as bone substitutes represents a major tool in bone regeneration. The author speaks about the various options concerning both bone grafts and biomaterials in face bone regeneration and the impact they may represent in anti ageing medicine.

Organic Cosmetics Vs natural or conventional Cosmetics: principal constituints investigated for potential dangerous efects on human health and alternatives in Organic Cosmetics

Many of today’s beauty products are made up of varying mixtures of synthetically produced chemicals and these chemicals vary in their ability to penetrate the skin. Some are absorbed in small amounts, while some easily reach the blood vessels below the skin and are transported around the body. Conventional cosmetics have a lot of these synthetically produced chemicals, permited by law, while some natural products may contain very small amounts of these ingredients, what is concern for us and many others is the cumulative effect of applying various products regularly. Many chemicals found in cosmetics do not cause obvious immediate signs of toxicity, but might slowly damage us through repeated use on our skin and we ...have grave concerns over the long term effects this may have on our bodies. Many drugs on the market today are administered through transdermal skin patches, which have been shown to be very effective. This demonstrates that the skin, the largest organ of the body and our first line of immunity, absorbs products and their ingredients. So if you put it on your skin, you can safely say you have eaten it! And all these were the main reasons of the organic cosmetics development. There are currently no laws to guarantee that health and beauty care products labelled as natural don´t contain these chemicals or even a product labelled organic are indeed organic. EU organic regulations only cover farming and food production.
Over the last few years there have been certain cosmetic ingredients that have been highlighted in the media due to their links with health scares, which has led some people to choosing organic as a safer alternative. A certified Organic Product offers you the reassurance that all of the ingredients are safe for you and your family. In addition people that suffer from sensitive skin or conditions such as eczema or psoriasis report that organic skin care products work better for them as they contain either tiny amounts of synthetic chemicals, or no synthetic chemicals at all.
So, what to search for? The safer way to choose a cosmetic without these chemical substances are seek for a product that has been independently verified as organic. The standards also contain criteria that means ingredients must be assessed to not be harmful to human health and their manufacture and use must cause minimum environmental impact. The standards are based on principles that require the maximum amount of organic ingredients, minimum synthetic ingredients, minimum processing of ingredients and clear labelling so that you can make an informed choice about the product you are purchasing.To be organic can not used: Artificial Colours or Fragrances, GM Ingredients, Dioxins, Petrochemicals, Mineral Oils, Parabens, Animal derivatives, Imidazolidinyl Urea, Propylene Glycol, Petrolatum, Hexane, Phthalates, Sodium Lauryl Sulfate or Sodium Laureth Sulfate, Aluminium & Animal Derived Ingredients. The strength of the certification lies not only in what you must include (Organic ingredients), but also what you may not use.
But then comes out other big issue: manufacture problems. How to preserve the products, how to keep nice textures or strong smell? Some alternatives can be presented and their limitations too. Safest formulations and highest standards of quality without sacrifice the performance – the future path. Having the best of the 2 worlds.

No Abstract Currently Available. Please check closer to the Congress Date.

Animal Welfare and Human Health

The impact on human health of stress metabolites produced by animals (including fish) due to poor welfare, perception of pain and suffering are debated. Public health risks associated with industrial farming and the detrimental effects upon the environment caused by this spreading method of meat and fish production are also discussed. The ethical cost of industrialized animal production is considered as a final note.

ANTI-AGING ARTICULAR PROCESS

The author is going to discuss a new orthopaedic chapter which will involve 20 percent of the world population in 2020, 60 million people will be over 65 years old.
This situation will increase the vulnerability of the musculoskeletic system, as osteoarthritis of the knee and ankle, will affect 40-60 percent of the population.
To maintain good articular health we have sysadoas, where we include glucosamine, condrotine and hyloronic acid. Glucosamine and condrotine contribute to the cellular protection, condrocit protection and maintenance of the structural support of the cartilage. The hyloronic acid concentration of the synovial liquid is diminished, so that the visco supplementation treatment begins to be important.
This process consists of a series of intra articular injections with the objective of improving the quality, the lubrification and ...the shock absorbance.
The authors revise the recent concepts and therapeutic forms whose goal is to prevent and treat the anti-aging articular process.
Finally, we will discuss articular reconstruction surgery as the last concept of quality of life

Inflammatory hormones and pathological aging-a new global concept

The aging process remains unknown in great part, despite some partial advances in medical research. We need a new macroscopic perspective of this infinite complexity that may integrate several theories and the actual knowledge and find the Arianne String of the pathological aging process, so we may develop new effective anti-aging treatments of the real causes instead of the actual multiple symptomatic treatments.
This presentation analyses the several stages of the metabolic syndrome and the inflammatory hormones as its biochemistry basis, first related with high carbohydrates intake of our current diet, then related to weight excess in the thirties(fat is the main inflammation hormones producer) and highly aggravated in the forties by sleep breathing disorders, not only sleep obstructive apnea, but including snoring, ...upper airways resistance syndrome due to laxity of the oropharinx muscle walls with aging.
We emphasize the chronic pro-inflammatory state of the forty and fifty decades and the central role of the inflammatory hormones in the physiology of pathological aging, as cardiac dysfunction, drowsiness and fatigue, arterial hypertension and the higher levels of aldosterone causing renal, hepatic and cardiac fibrosis, night brain edema and headache, the role of night chronic facial edema and eritrasma in facial flaccidity including blepharochalasia, the arthrosis and a possible explanation of higher number of cancer cases in aging due to high level of inflammatory hormones.
We analyse the new perspectives of anti-aging treatment based in this new inflammatory paradigm- the surgical treatment of snoring, sleep apnea, the use of aspirin , non steroid anti-inflammatory drugs, omega 3, the possible new use of propanolol, the role of diet and muscle exercises in avoiding metabolic syndrome, lowering the inflammatory hormones levels so we may have a healthy aging. The refocusing of the inflammatory hormones as the central key of the pathological aging can lead to new paradigms in the treatment and real prevention of the diseases related to aging process, overcoming the current dogma of fatality and impotency.

Anxiety: gaining control how your feel

Os estudos clínicos no mundo inteiro salientam a evidência das perturbações ligadas ao stress, na sociedade ocidental; a ansiedade e a depressão ganham destaque. Segundo os primeiros resultados do estudo epidemiológico nacional de saúde mental, 23% dos portugueses tiveram uma doença mental nos últimos 12 meses e ainda segundo o mesmo estudo, as perturbações psiquiátricas mais frequentes na população portuguesa são a ansiedade (16,5%) e a depressão (7,9%). No presente trabalho trataremos da ansiedade que é caracterizada como sendo um problema psicológico que se traduz por um sentimento de insegurança, ou medo sem fundamento real. A resposta ansiosa é uma reacção defensiva instantânea face ao perigo ou ao stress, exercendo uma função protectora. Acredita-se que a sua causa se deve a uma combinação de agentes biológicos e ...ambientais (factores de ordem genética, química cerebral, personalidade e acontecimentos de vida). A sintomatologia está associada a um sofrimento substancial, permanente e persistente (seis ou mais meses) e não pode ser atribuída ao uso ou abuso de uma substância ou a uma condição médica geral. Neste sentido, consideramos que uma terapêutica eficaz envolve uma abordagem holística e multidisciplinar que contemple distintas áreas de intervenção, tais como, psicoterapia (com especial relevância à hipnose clínica), meditação, fototerapia, homeopatia, osteopatia, acupunctura, a própria alimentação, actividades físicas entre outras.

Sexual Disturbances after Menopause

Menopause itself is simply one event in the whole range of the anatomical, physiological and psychological changes that a woman may experience during the transition period from fertility to the infertility days. Decrease in the intensity of orgasm and libido is a complex problem and multiple factors can play here a pivotal role. About the aging process, the author reminds the impact of the interpersonal, biological, psychological and socio-cultural factors on libido and how they can affect a woman and her partner. Sexual disturbances need multidisciplinary anti-aging approach for aging in health and dignity, including self-education, lifestyle changes and hormonal or alternative therapy. After all, “sexual wellbeing is not a luxury, it’s a right.”

No Abstract Currently Available. Please check closer to the Congress Date.

Meso Multivitamins: effects on skin rejuvenation

Mesotherapy is a scientifically customised blend of vitamins, Hialuronic acid and anti-oxidants that improves the skin quality and appearance using multiple micro injections into the superficial layers of the skin. It can be used on in the face, neck, décolletage and the the back of hands (dorsum) for skin revitalisation that works by improving skin elasticity, hydration and skin tone. By replenishing the natural hyaluronic acid in the skin, improves hydrobalance to increase skin elasticity. Mesotherapy is safe and compatible with all other treatments, such as dermal fillers, chemical peels and muscle relaxing treatments.

Melatonin in the successful managing of aging

Melatonin, the most studied pineal hormone, is synthesized and secreted during the dark period of the light-dark cycle and the duration of the nocturnal production is proportional to the length of the night. The melatonin rhythm is an important hormonal signal from the “clock”, which conveys circadian and day length information to any structure or organ that can read it. Melatonin is a multifunctional indolamine with proved anti-oxidative and anti-inflammatory properties. The discovery of melatonin and its derivatives as antioxidant agents has stimulated several studies, which have documented the capability of these molecules to reduce damages induced by oxidative stress. These findings may have clinical implications given that many age-related diseases in humans have important free radical component. An important theory explaining aging ...process suggests radicals and their derivatives as essential causative agents (Free radical theory of aging). The oxidative hypothesis of senescence, has given evidence and support that free radicals play a crucial role in aging, either as damaging agents or as signalling factors. These conditions, coupled with the loss of melatonin during aging, suggest that some diseases and some aspects of aging may be aggravated by the diminished melatonin levels in advanced age. Administration of melatonin, which has a very low toxicity profile, could slow down the progression of some diseases and, possibly prevent signs of aging. Certainly, future research will help to define the role of melatonin in age-related diseases and in determining successful aging.

Intimidade Sexual

Falar de intimidade é falar da exposição ao outro, da comunicação dos aspectos subjectivos, como sentimentos, sensações e emoções e do significado e intenções dadas aos comportamentos da interacção. A reciprocidade entre parceiros é uma característica inerente ao processo interactivo. Dar e receber, ou seja, a partilha das vivências íntimas, é uma componente dinâmica da interacção. O que parece simples, torna-se complexo, quando se fala de comunicação da vulnerabilidade humana e das limitações reconhecidas, ao identificar e expor a realidade interior. Quando se designam competências para o desenvolvimento da intimidade, a referência mais importante é o processo de comunicação. A comunicação entre duas pessoas de uma vivência interior em relação ao exterior, em relação a si próprio e em relação ao outro. Neste âmbito, a comunicação ...da realidade interior, associa-se aos sentimentos, às sensações, às emoções, aos pensamentos, quer positivos ou negativos que se estruturam no dia a dia, em consonância como uma realidade exterior e de acordo com intenções e expectativas dos parceiros. Este processo, da comunicação da subjectividade individual entre duas pessoas, cria um tipo de envolvimento ou ligação pela comunicação, que torna o próprio processo mais complexo mas também mais gratificante em termos individuais e relacionais. Falar de menopausa e andropausa é falar de uma fase de transição, onde terminam alguns aspectos da vivência individual e existe a necessidade de redescobrir outros igualmente gratificantes de forma a encontrar satisfação e inerente qualidade de vida. Um relacionamento conjugal, pelas suas características, permite estruturar e orientar a relação enquanto vivência e desenvolvimento da intimidade, conduzindo à satisfação individual e relacional. Esta apresentação tem por objectivo privilegiar o Conceito de Intimidade, reconhecer as alterações fisiológicas e emocionais da sexualidade e referenciar a importância da intervenção terapêutica ao nível da prevenção da qualidade de vida, em particular na Reeducação Sexual no envelhecimento.

It may seem premature to be discussing the elimination of human aging as a cause of death, when so little progress has yet been made in even postponing it. However, two facts undermine this assessment. The first is that aging happens throughout our lives but only causes ill-health after middle age: this shows that we can postpone that ill-health without knowing how to prevent aging completely, but instead by molecular and cellular repair. The second is that the typical rate of subsequent, incremental refinement of big technological breakthroughs is usually fast enough (so long as public enthusiasm for them is strong) to change those technologies almost beyond recognition within a natural human lifespan. In this talk I will explain, first, why therapies that can add 30 healthy years to the remaining lifespan of typical 60-year-olds may well arrive within the next few decades, and, second, why those who ...benefit from those therapies will very probably continue to benefit from progressively improved therapies indefinitely and will thus avoid debilitation or death from age-related causes at any age.

Revitalisation and Mesotherapy with new techniques that give a “flash effect“ to the skin of  the face, neck, decolte and hands, with immediate results of the surface. Discussion of the “nappage“ procedure to get a natural appearance.

Várias aplicações da Mesoterapia à Estética

A Mesoterapia , como técnica médica já bastante reconhecida pelos seus resultados em vários tratamentos na Medicina em geral, tem vindo a ter cada vez mais um papel preponderante na área da estética Médica com excelentes resultados, só por si, como tratamento único, ou associado a outros tratamentos, em complementaridade, potencializando-os.
Essas aplicações são várias, sejam como tratamento dos efeitos do envelhecimento, nomeadamente na pele do rosto, mas também como tratamento na prevenção e atraso do envelhecimento dessa mesma pele. Esse último tem um papel muito importante no tratamento anti-envelhecimento que tem tido, cada vez mais, ênfase na prática dos clínicos que praticam esses tratamentos. Como já todos sabemos, melhor do que tratar, é não deixar que aconteça, e prevenir.

The hippocampus, as the major role between emotional stability and longevity.
In his research following personality traits and longevity, Terracciano, concluded after 50 years continuous that the individual emotionally stable, active and conscious, live on avarage of 2-5 years more than those who are not. Depression, is now a days, considered a major risk factor for death. In 1988, Peter Sterling and Joseph Eyer concluded that lost of cortisol release control due to stressful life, are associated with tipical aging deseases . Hippocampus is involved in the acquisition of new memories, neurogenesis, cortisol release and his malfunction , is associated with severe depression symptoms.
Several hormones and neurotransmissors are responsible for the good function of the hippocampus, which can be the key structure to understand the connection between hormones replacement therapy, nutritional ...supplementation, antioxidants, antidepressives drugs, life style and healthy longevity.

Evolutionary aspects of healthy eating
Lindeberg S. Dept of Primary Health Care Research, Lund University, Sweden staffan.lindeberg@med.lu.se

Abstract: Increasing evidence suggests that the relative intake of fat, carbohydrate and protein is of limited importance in the prevention of common Western diseases. Cardiovascular health has been excellent among non-western populations consuming vastly different proportions of macronutrients, as illustrated by Eskimos (low-carb) and Pacific Islanders (high-carb). During human evolution, meat-to-plant ratio and macronutrient composition must have varied considerably, with intakes often exceeding the limits suggested in any particular dietary model based on macronutrients. In contrast, Western people acquire 70 % or more of dietary calories from foods that were practically unavailable during human evolution, mainly cereals, dairy ...products, refined sugar, fats and oils.
In animal experiments, atherosclerosis is promoted not only by dietary fat (any type) but also by bioactive substances from grains (e.g. lectins) and milk (e.g. casein). In our own research, we have found an ancestral diet based on vegetables, fruit, root vegetables, lean meat, fish, eggs and nuts to be satiating and effective against the metabolic syndrome in humans and pigs.
Hence, ancestral diets may be the optimal choice for prevention and treatment of age-related degenerative western diseases, including cardiovascular disease, diabetes, obesity, insulin resistance, hypertension, dyslipidaemia, age-related dementia and some forms of cancer.

Reference. Lindeberg S. Food and Western Disease. Health and Nutrition from an Evolutionary perspective. Wiley-Blackwell, 2009.

No Abstract Currently Available. Please check closer to the Congress Date.

HOW NUTRIENTS CAN MODIFY GENE EXPRESSION
ReGENERA Research Group., Milano, Italy (www.regeneragroup.com) and WHO-cnt for Biotech & Trad. Med., University of Milano, Italy

Nutritional/nutraceuticals issues involved in any tentative prevention strategy are known to be the most important environmental epigenomic modifiers. Moreover, from the human genoma project conclusion, a post-genomic era has started, which represents an ideal match with tailored nutraceuticals, thus leading to a nutrigenomics evolution. Nutrigenomics mainly aims at studying genetic and epigenetic interactions with a nutrient as to lead to a phenotype change and therefore to the cell metabolism, differentiation or apoptosis. Such new nutraceutic perspective entirely depends on the growing development of new innovating solutions aiming at acting on organic systems. A biochemistry and molecular biology specific ...development together with biotechnological methods have been enhanced as to support the hypothesis that some nutrients could modulate the body functions. Such assessments has to be in line with consistent markers identification, both directly connected (functional factors) to the process to be modified as well as indirectly associated (indicators). This would play a definite role in general good health conditions as well as in the potential reduction of disease risk occurrence within a synergistic-integrated approach in established therapeutic regimens.


AGING AND DYSBIOSIS: EXPERIMENTAL BASIS & THERAPEUTIC PERSPECTIVES
Marotta F1, Yadav H2, Signorelli P1, Lorenzetti A1, Jain S2, Polimeni A1,
1ReGenera Research Group for Aging-Intervention, Milano, Italy; 2NIDDK, National Institutes of Health, Bethesda, USA;

Gut functionality is strictly linked to gut microflora: numerous different bacterial species live in a dynamic equilibrium in this organ. The prevalence of some species, compared with the others, may influence the development of these functions. Several disorders, infections and severe pathological conditions are very often accompanied by alteration of the microflora balance. A number of dietary and life-style modification as well aging per se have been suggested to alter such balance and the extent of the related local and systemic consequences haven’t still been thoroughly unfolded.
Probiotics, available also in several food and drinks products, are microrganisms (usually bacteria) able to reach alive and active the intestine where they can benefit the host. Each probiotic strain may act differently and benefiting the host in several ways: contributing to maintain the microflora balance, improving the presence of beneficial bacteria and inhibiting the development of harmful bacteria, contributing to food digestion, stimulating elimination of toxic compounds or diminishing enzymatic activities related to the production of dangerous molecules.
The interest of scientific community for probiotics increased in the last 10 days and a crescent number of papers are available related to that topic. Several papers aim to evaluate the possible application of probiotics in relation with other drug therapy during diseases treatment. However, probiotics may contribute to support microflora balance and gut functionality also in healthy subjects. For that purpose, some recent publications are evidencing the benefit of a daily intake of probiotics: improvement of microflora balance, enzymatic activities modulation during digestion and stimulation of the immune system in healthy subjects. On the other hand, the genomic assessement of gut flora may prove to be of paramount importance, expecially when trying to address the biodiversity changes during aging and disease-related process. In this evolving scenario, “bio-engineered” probiotics are potential amenable tools of “therapeutic” potential while further researches are needed to exhaustively evaluate the mechanisms responsible for these activities and their benefits on the long run. However, it is evident the contribution of these microrganisms not only in association with drug therapy but also in supporting gut health and functionality in age-intervention management strategies.

Genomics,Proteomics & Other “omics“ in Oncology

Pharmacogenomics, Transcriptomics, Genomics, Metabolomics, Interactomics, Immunogenomics, Genomics, Proteomics an other omics are currently more common nouns in the field of Biology and Medicine. We may consider that “..omics“ may be the comprehensive analysis of biological systems whether you are focusing your attention in DNA, RNA, Proteins, Metabolites or other molecules. Cancer development and progression is under the dependence of high complexity systems that may also influence the response to therapeutics an tumor behavior.Since we made the introduction of a Pharmacogenomics and Molecular Epidemiology Class in the Faculty of Medicine of Porto (2004) and in the Biomedical Sciences Institute (ICBAS, 2006) an increasing number of researc reports have  been published demonstrated the importance of the “omics“ research field in ...Cancer Biology and Oncology.A comprehensive review will be presented pointing more recent practical examples(Cancer Chemother Pharmacol.2009;Pharmacogenomics J. 2009 Oct;9(5):341-6;Exp Biol Med 2009 Mar;234(3):241-5;Eur J Gastroenterol Hepatol. 2009 Jan;21(1):76-91; DNA Cell Biol. 2008 Aug;27(8):415-21; Clin Cancer Res. 2008 Jun 1;14(11):3367-71;Cancer Genet Cytogenet.2008 May;183(1):35-40;DNA Cell Biol. 2008 Jun;27(6):333-6;Prostate Cancer Prostatic Dis. 2008;11(1):94-8;Gynecol Obstet Invest. 2007;64(4):208-12.;Breast Cancer Res Treat. 2008 May;109(1):183-5;Oncologist. 2007 Feb;12(2):201-10;Breast Cancer Res Treat. 2007 Jun;103(2):209-17;J Neurooncol. 2007 Feb;81(3):225-9;World J Gastroenterol. 2006 Aug 21;12(31):5033-6;Head Neck. 2006 Jul;28(7):603-8; Eur J Cancer. 2006 May;42(8):1188-93;Eur J Cancer. 2006 May;42(7):958-63.Eur J Clin Pharmacol. 2006 Jan;62(1):15-21;Biochem Biophys Res Commun. 2006 Feb 3;340(1):256-62;Cancer Immunol Immunother. 2006 Jun;55(6):639-43;Prostate. 2005 Aug 1;64(3):246-52.;Cancer Genet Cytogenet. 2004 Nov;155(1):42-6.;Angiogenesis. 2004;7(1):53-8; J Pathol. 2004 Mar;202(3):330-5;Int J Clin Oncol. 2003 Jun;8(3):156-61. Several new fields of research including stem cells may open new “omics“ in Oncology and other diseases.

The effects of endocrine disruptors on health

The author provides a brief overview of human and animal health studies that outline the risks associated with environmental estrogens and hormonally active agents. The author also offers a scientifically based opinion on the effects of these endocrine disruptors in reproductive and developmental health, including: breast cancer, endometrial cancer, precocious puberty, fecundity and fertility, spontaneous abortion, sex ratios, prostate cancer, ovarian cancer, testicular cancer, thyroid hormones and immune system. Sources of environmental contamination are outlined. The potential medical, legal, economic, social and ethical implications associated with the effects of these agents in the general population are also briefly addressed.

Healthy Caloric Restriction for Greater Longevity

The determinants of length of life are multifactorial and involve complex processes, most of which are not as yet understood completely. Tremendous advances have, however, been made in recent times in understanding some of the key molecular mechanisms that influence ageing and lifespan. Herein we highlight many of the more important findings and their potential clinical implications. Most of the intracellular factors involved in the ageing process, such as members of the sirtuin family, as well as insulin and insulin-like growth factor-I and their genes, are part of interconnected pathways.
Endogenous antioxidants, such us resveraterol, inversely correlate with maximum longevity in animal species and experiments modifying levels of these antioxidants can increase survival and mean life span but not maximum life span (MLSP). The available ...evidence shows that long-living vertebrates consistently have low rates of mitochondrial free radical generation, as well as a low grade of fatty acid unsaturation on cellular membranes, which are two crucial factors determining their ageing rate. Oxidative damage to mitochondrial DNA is also lower in long-living vertebrates than in short-living vertebrates. Calorie restriction, the best described experimental strategy that consistently increases mean and maximum life span, also decreases mitochondrial reactive oxygen species (ROS) generation and oxidative damage to mitochondrial DNA. Recent data indicate that the decrease in mitochondrial ROS generation is due to protein restriction rather than to calorie restriction, and more specifically to dietary methionine restriction. Moreover, it was recently found that 80% methionine restriction substituting it for l-glutamate in the diet also decreases MitROS generation in rat liver. Thus, methionine restriction seems to be responsible for the decrease in ROS production observed in caloric restriction. This is interesting because it is known that exactly that procedure of methionine restriction also increases maximum longevity. Moreover, recent data show that methionine levels in tissue proteins negatively correlate with maximum longevity in mammals and birds. All these suggest that lowering of methionine levels is involved in the control of mitochondrial oxidative stress and vertebrate longevity by at least two different mechanisms: decreasing the sensitivity of proteins to oxidative damage, and lowering of the rate of ROS generation at mitochondria.
In young and middle-aged healthy individuals, however, CR causes many of the same cardiometabolic adaptations that occur in long-lived CR rodents, including decreased metabolic, hormonal and inflammatory risk factors for diabetes, hypertension, cardiovascular disease and cancer. Unravelling the mechanisms that link calorie intake and body composition with metabolism and aging will be a major step in understanding the age-dependency of a wide range of human diseases and will also contribute to improve the general quality of life at old ages. Greater longevity would be partly achieved by a low rate of endogenous oxidative damage generation, but also by a macromolecular composition highly resistant to oxidative modification, as is the case for lipids and proteins.

Orthomolecular Approach in Intestinal Disbiosis and Leaky Gut Syndrome

The Intestinal Microflora represents 80% of the human acquired immunity. In 400 m2 of Intestine, there are 2000 m2 of microscopic structures, 100 billions microbes, 500 distinct species. For 1012 human cells, we find 100 times more microorganisms. Medium to severe Disbiosis and Leaky Gut Syndrome with inflammatory recurrence is epidemic nowadays in most of the individuals. Understanding the balance and physiology behind the mucosal associated immunity and the microecolgy mechanisms is the key point to prevent and treat direct and indirect intestinal coming pathologies. The orthomolecular medicine approach of intestinal immunoregulation has been shown to be successful in the resolution of chronic Chron’s Disease, Inflammatory ...Bowel Disease, Atopic Dermatitis and Obesity. The correct use of molecular bioactive dietary supplements and probiotics is able to guarantee the best flora pH, metabolic vitamins synthesis, regulating oxidative stress associated hormones and IgE dependent histamine, increase the stimulation of s‐IgA, CD4 and CD8 T cells in immunosuppressive patients, induce the beneficial action of the Regulatry T‐Cells (Tregs) in autoimmune situations, shut off the transcriptional activation of the Tool‐Like Receptors and NF‐κβ, as well as correct the injured cell membranes due to inflammatory processes. The orthomolecular concept in anti‐ aging and functional integrative medicine is a valuable tool for doctors intending to give their patients the best natural life quality with less chemical adverse side effects intervention.

The role of spirituality in the aging process

We live in a world dominated by material objectives and concerns. It is these which condition the main decisions taken both at an individual and global level. The evolution of science, technology and economy does not go hand in hand with the cultivation of the human qualities of solidarity, goodness and compassion. The development of medicine now permits us to fight illnesses more effectively and increase the life expectancy of millions of people. However, there is little concern for the finding of inner peace and serenity. In a world like ours the importance of spirituality is largely overlooked.
Over the last decades many people thought that in order to be happy it was enough to muster all the material conditions for wellbeing and comfort. We now know that this is not the case. Perhaps this is why we are much closer to recognizing the value ...and importance of our state of mind in the way in which we interpret and weigh up reality.
Many think spirituality has nothing to do with daily life and they rarely understand that everything which happens to them, at every instant, is set in the context of their vision of the world. Depending on this vision, every event is evaluated in terms of happiness and suffering, determining our overall feeling of satisfaction or dissatisfaction in relation to life. The event itself is only endowed with the significance we give it.
But this is not all. How much of our suffering is created or perhaps aggravated by our own mind! In any difficult situation fear, speculation and revolt often make us suffer much more than the situation in itself. In these cases our mind becomes our worst enemy.
The most recent studies on the body and mind relationship reveal that the positive or negative functioning of the mind and body are related: negative emotions weaken the immune system, aggravate symptoms and hinder recovery. All negative states of mind cause stress and are directly connected with physical problems like high blood pressure, cardiovascular diseases, production of age-accelerating hormones and others.
On the other hand, positive emotions have a therapeutic effect, increase immunity and longevity. When one is at peace inwardly, feelings of love and compassion are natural and effortless, and one easily finds meaning in life.
Therefore, if we want to find happiness and develop the ability to enjoy life at its fullest, mentally and physically, the need to work on the mind becomes obvious. The recognition of the primacy of the mind in all human actions, and the need to train it in order to achieve happiness, peace and meaning in our lives brings about spirituality as the means and the methods to do so.

Impact of human activity on the environment

The human activity has always an impact on the environment. It is impossible to have any kind of activity without impact on the environment. With this presentation the author will try to show the human activities that have more impacts and what should be done to try do reduce that impact.

No Abstract Currently Available. Please check closer to the Congress Date.

Endothelial Dysfunction: accumulation of vascular risk factors and aging. the effect of anti-oxidants in the improvement of erectile function

1) Department of Biochemistry (U38/FCT), Faculty of Medicine of the University of Porto, Porto, Portugal
2)Laboratory for Molecular Cell Biology, Faculty of Medicine of the University of Porto, Porto, Portugal
3) iSEX, Association for the Advanced Study of Human Sexuality, Lisboa, Portugal

Metabolic disorders and oxidative stress are key correlates for the development of endothelial dysfunction and loss of erectile function. The deleterious actions of these factors promote the disruption of endothelial biological activities, causing endothelial malfunction. The endothelium plays a crucial role in systemic vasodilation and hemodynamic events, including the ones involved in erection physiology. Due to these ...relevant functions, a close link has been established between endothelial integrity, erectile dysfunction (ED) and cardiovascular disease (CAD). In fact, it is currently recognized that ED may be the first clinical manifestation of a generalized vascular disorder and should be considered as an alert for future cardiovascular events. Obesity, lipidic disorders, hypertension, diabetes and the associated excess in oxidative stress have been identified as key vascular risk factors (VRFs) for ED and CAD, having as common denominator generalized endothelial dysfunction. This link suggests by controlling VRFs, either through life changing habits or by the use of medications and/or supplements, endothelial and erectile function could be concomitantly improved. But can in fact endothelial health be recovered and ED ameliorated? Several studies have indicated that endothelial and erectile function may benefit at some extent from a reduction of VFRs and from a decrease in oxidative stress. However we must be aware that a persistent exposure to VRFs and reactive oxygen species, besides altering nitric oxide bioavailability/bioactivity, may abrogate other endothelial cell vital mechanisms, compelling them to enter programmed cell death. The severity of endothelial apoptosis may dictate if vascular regeneration may occur or if vascular deterioration may endure. In fact, recent studies from our group have shown for the first time a close link between endothelial apoptosis levels and ED in diabetic men. We provided evidence that established diabetes, promotes severe cavernosal endothelium dysfunction through the activation of the apoptotic process. Cavernosal tissue of diabetic patients with ED has increased endothelial apoptotic cell density (ACD), as compared to non-diabetic non-ED individuals. More importantly, ACD was shown to correlate with penile function assessed in a preoperative stage by the Penile NO Release Test (PNORT), allowing us to establish a threshold between ACD values and cavernosal endothelial functionality. Our results, besides supporting the crucial role of endothelial integrity in erection physiology, highlight to the benefits of early intervention measures to control VRFs. Additionally, we reinforce the importance of a throughout evaluation of endothelial health in ED patients in an earlier stage, before endothelial systemic disease is manifested.

Dermamelan is a professional depigmentation treatment. Very effective for melasmas imperfections and hyper-pigmentations.
After a month of application, the results are spectacular.
It is a combination of selected ingredients including different acids, which principal action is a reversible and non cytotoxic inhibition of the Tyrosinase, the core of the commun methabolic pathway of the melanins pigments synthesis. Since some other principles from the formula have not only a depigmentation indication; Dermamelan can also be considered as a complete anti-aging program with a visible improvement of wrinkles and flaccidit
As it is formulated in Mesostetic pharmaceutical laboratory, the concentration of the ingredients is very high. This fact allows a deep and effective penetration of actives which goal remains to reach the target, the melanocyte, and more precisely the melanosome where the ...melanin synthesis occurs, and so where the Tyrosinase acts .
But this is not the only way Dermamelan is going to work for the depigmentation purpose. Other methabolic vias of the pigment synthesis process are going to be blocked. Thanks to the synergic action of the substances from the exclusive formula of Mesoestetic, as well as the protocol of application makes the treatment ideal to avoid post inflammatory hyper-pigmentations.
The pack contains, two jars. The mask for a unique application and the daily maintenance treatment. In order to remove all impurities of the area to be treated, the pack also includes a specific cleansing.

Understanding the Controversy: Hormone Testing & Bio-identical Hormones

As we age we lose hormones. Women are the ones that suffer the most with this issue. Despite the general opinion, a wrong one, they begin loosing hormones by their middle thirties, and the most remarkable lost is undoubtedly of progesterone.
This being said, it is easy to understand that Progesterone is the key to a healthy peri-menopause, since it prevents osteoporosis, fibroids and breast cysts. Towards a solution, they are regularly given progestin, which causes even more health problems.
It is often forgotten that women do have testosterone, and that the lack of this hormone wrecks havoc their libido, skin and bones. The community seems to be afraid of hormones, though bio-identical hormones are around four million years and are perfectly safe, otherwise young women would have breast and uterine cancer! ...These hormones are ours; they couldn’t manage to be more natural indeed, although not profitable for big pharma. The key for bio-identical hormones replacement therapy is to mimic woman’s normal cycle, while listening to her body necessities’. This should give us a fair balance between what that specific woman needs and the estrogen replacement possible. Hormone testing is not only a possibility but an imperative medical need.
In conclusion, we must bear in mind that hormones are all interrelated, and that symptoms are the ones in charge in what comes to replacement therapy.

Innovative fractional laser skin resurfacing therapy

The fight against the indelible signs of aging has been the cornerstone of resurfacing laser treatments and the CO2 laser is one of its principal weapons. However, being one of the most effective treatments when it comes to evaluating the downtime and the side effects, which are temporary but quite uncomfortable, no one was satisfied and this led to an understandable refusal to undergo these techniques in the majority of patients.
That is how the brilliant contribution of fractioning emerged to improve the safety range that is lacking in the conventional ablative system. The reduced recovery time has been the key to making this fractioned treatment popular yielding more than satisfactory results if we wisely choose the patients susceptible to receiving this laser therapy. Likewise with light therapies, we can combine them with other ...techniques such as fillers and botulinum toxin and obtain even better and lasting results.
The formation of crusts is normal in all ablative treatments, but after fractioning, not only are they more even owing to the distribution of the laser impacts on the skin surface by means of a scanner, but the time necessary for the crusts to fall and the healing process is considerably reduced with a similar effect to the one when the system was continuous. Furthermore, moving around and walking is much easier post-treatment given that the exudation and bleeding are minimal if we compare it to other treatments in the past.

The Role of Hormones in Aesthetics – An Essential Component of Integrative Rejuvenation Medicine

Over 25 years of private practice, we have developed a unique integrative approach to aesthetic enhancement of our patients which encompasses a holistic model which we term Rejuvenation Medicine.  In this model, we incorporate components of surgical and non-surgical Facial and Body Aesthetics, conventional (western) and alternative (eastern) therapies, dietary and exercise counseling, allergy evaluation and desensitization, and nutritional/hormonal assessment and supplementation.  The use of bio-identical hormone supplementation assists in the functional support of our surgical procedures, reducing per-operative bruising and discomfort, supports longevity of our surgical results, and increases overall patient satisfaction with the procedures performed. This new integrative approach to the care ...of the patient seeking aesthetic enhancement has led to our development of a new approach to our practice specialty, namely Cosmetic Surgery and Rejuvenation Medicine. The various aspects of our unique practice model, “Beauty from the Inside Out”, will be discussed.

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The Intra-Areolar Multi-W-Plasty Approach to Breast Augmentation – RejuvENHANCE ™ :the “No-Skin-Scar” Technique

Multiple surgical approaches have been proposed for breast augmentation using implants: infra-mammary, axillary, trans-umbilical and peri-areolar.  Each of these techniques lead to scarring.  We developed a unique technique of breast augmentation that prevents all incisions of the skin proper and, therefore, prevents all scarring of skin.  We describe our 25 year experience with the intra-areolar multi-w-plasty technique. This technique, which places an accordion-shaped incision restricted to a natural wrinkle within the areola provides for optimal direct access to the surgical pocket, provides optimum placement of the implant, minimizes tissue trauma and results in a well-cammouflaged surgical incision site.

No Abstract Currently Available. Please check closer to the Congress Date.

Insulin, Leptine and Cortisol, or the Nutrition, Exercise and Stress connection

A leptina, uma hormona libertada no tecido adiposo e cuja amplitude de funções só recentemente se conhece, modula o apetite através dos seus receptores específicos na hipófise.
Com um ritmo circadiano próprio, e dependente da melatonina, a leptina está sinergicamente relacionada com a insulina, nos metabolismo dos hidratos de carbono e lipogénese, e com o cortisol, na interacção neuropsíquica.
As alterações metabólicas conducentes à insulinoresistência entrecruzam-se com as da leptinoresistência e com os desequilíbrios dos níveis de cortisol.
A obesidade e a síndrome metabólica, evoluem a par de um apetite insaciável e de uma fadiga continuamente crescente.
Pela compreensão da conexão insulin - leptina – cortisol percebemos que a estratégia do seu tratamento e ...da manutenção do seu equilíbrio passa pela intervenção médica, pela nutrição, pelo exercício físico e pelo stress manegment, uma estratégia fundamental em Medicina Anti-aging.

No Abstract Currently Available. Please check closer to the Congress Date.

Why Exercise?

The aging process, namely in developed countries, has many implications in public health and related costs. Although many physiological function are well known to decline with age, it is recognized that reduced physical activity further increases functional losses that may increase physical frailty, morbidity and mortality. Body composition changes with aging include an increase in whole body and abdominal fat, and a decrease in muscle tissue mass. Adipose tissue distribution and the amount of visceral adipose tissue are independent determinants of morbidity. With increasing age, longitudinal and cross-sectional data suggest that fat becomes more centralized, with a redistribution of subcutaneous fat from the limbs to the trunk. Detailed analyses with laboratory methods such as computerized tomography and magnetic resonance imaging, show that the amount of visceral fat increases ...in men and women with aging. Visceral fat has been hypothesized as being the most unfavorable body composition variable, and together with other metabolic risk factors such as insulin resistance, hyperinsulinemia, blood lipids and hypertension is considered an essential element of the plurimetabolic syndrome. The age-related decline in muscle mass has some unhealthy and functional effects reducing the ability to perform common daily activities that require strength and muscle resistance. Physical activity involving aerobic exercise or resistance training can induce selective body composition changes and play an important role in health by preventing abdominal obesity (visceral and subcutaneous), and sarcopenia, and osteoporosis. Current knowledge suggests that resistance training may be more effective in preventing sarcopenia, while aerobic exercise may induce higher benefits in abdominal obesity and whole body fat mass. Changes in muscle composition brought about by aging, such as increases in intramuscular adipose tissue, decreases in muscle cell mass, and changes in muscle and fat distribution highlight the need for sensitive methods to measure body composition changes that are associated with aging and exercise. The research carried out in our laboratory in the area of body composition, physical exercise, and the sarcopenic-obesity syndrome suggest that aerobic exercise and resistance training have relevant prophylactic effects. Muscle quality increases, and total and abdominal fatness decreases. Epidemiological research further suggests that physical activity and cardiorespiratory fitness independently improve body composition and functional independence, and increase survival.

Conventional oncology aims at treating cancer by destroying tumor cells. Integrative Oncology also includes strategies to change the tumor`s micro-environment and to stimulate the body`s natural defenses against cancer growth. Genetics account for at most 15% of cancers. The rest can be attributed to a combination of life-style and environment. Harnessing new discoveries on the role of nutrition, physical activity, stress management and control of environmental contaminants can have a significant impact on cancer prevention, but also on slowing cancer growth and markedly improving survival as quality of life in patients already diagnosed with cancer. In view of the existing scientific evidence, modern oncology should include a combination of conventional treatments with integrative approaches.

Everyone knows the power of a beautiful smile. We are living very exciting times when it comes to what we can provide for our patients,their overall appearence and function.We have a vast array of  knew techniques ranging from surgical proceadures,implants,tissue regeneration,orthodontics to adhesive porcelain. We will discuss porcelain veneers,a very powerfull anti-aging tool, which can provide dramatic results with a minimally invasive technique. We´ll go through the basic steps involved in the “making of” and look at a number of before and after cases.

The Liposuction revolution: Laserlipolisys

Laserlipolysis of high potency provide aesthetic surgeons with a less invasive technique than conventional liposuction methods for fat reduction and body toning. As the industry`s only laserlipolysis system designed to destroy fat cells and coagulate tissue for tighter skin, this technique is ideal for treating localized fat deposits on the face and body. In addition, laserlipolysis systems can easily treat challenging areas—such as regions of high vascularity and flaccidity.Sequentially emitting wavelengths are safe and effective and we have observed improvement in skin texture and skin tightening. Sequential laser exposure with two wavelengths is through to be more effective than either laser alone.On the final results we have observed reduction in fatty tissue volume and skin laxity, 15% tightening of overall treated area after 1 month and a ...very high patient satisfaction. Conclusion:
Blending 1064 nm and 1320 nm provides excellent results and added safety.
Ability to generate higher temperature to a broader area while distributing the laser energy more evenly
More efficient and safer lipolysis
More efficient heating of collagen bundles in the dermis.
Dr. Serres will present a lot of cases before and after in different body parts.

Insulin resistance (IR) it’s a condition where basal values of insulin are inadequate to produce a normal insulin response in skeletal-muscle, adipose tissue and liver cells. Insulin resistance in muscle cells reduces blood glucose clearance, whereas IR in liver cells causes impaired glycogen synthesis and a failure to suppress glucose production. These circumstances lead to a state of hyperglycemia, which leads to hyperinsulinemia which is believed to be one of the factors that contributes to the development of diabetes type 2, a condition that it’s increasing prevalent in modern societies. An increase in the concentration of insulin in the circulation stimulates the synthesis of triglycerides (lipogenesis) that can also be important to understand the epidemic of hypertrigliceridemia. Insulin also decreases lipolysis, the breakdown of fat for utilization by the organism, by direct action on hormones ...responsible for the hydrolysis of triglycerides to fatty acids. On the other hand, physical exercise (PE) is consensually accepted as an efficient strategy to prevent increases in body weight, fat mass accumulation and the development of chronic diseases. One of the mechanisms in which PE can help decrease risk factors for metabolic problems it’s due to adrenergic action in the organism. Exercise releases hormones: adrenalin, noradrenalin, thyroxin, testosterone, estrogens, and glucagon, which increases lipolysis, mobilizing fat stores in the skeletal muscle and in the adipose tissue releasing energetic substrates for oxidation needs. It is of the greatest importance for the success of an exercise program or an exercise intervention to control for the insulinemic state of the participant, either if it’s a clinical condition, or with a subject that it’s apparently healthy. The frequency, type and volume of the PE needs to be adjusted to the needs of the participant, not only in a macro-perspective (decrease in adipose tissue, decrease in glycemia), but also at the molecular level, in the action of enzymes and hormones that are associated with lipolysis and lipogenesis processes. Concurrently, the diet needs to be included in the “intention to treatment”, due to the deleterious effects that macronutrients, both in their quality and the quantity, have on the metabolic effects of PE.

Face-lift em 3 planos

Esta apresentação aborda o rejuvenescimento facial de uma forma anatómica, realizado em 3 planos distintos. As técnicas cirúrgicas apresentadas consistem no “elevar“ da face para onde a mesma estava 10 a 20 anos antes, com uma adaptação cutânea, em oposição à forte tracção da pele dos lifts “clássicos“, para assim se obter um resultado mais harmonioso.
É feita uma a comparação das técnicas tradicionais com o “novo“ face lift, através da apresentação de trabalhos do mesmo autor.

THE OMEGA-6/OMEGA-3 RATIO IN HEALTH AND DISEASE

The Center for Genetics, Nutrition and Health
Washington, DC 20009 USA

Several sources of information suggest that human beings evolved on a diet with a ratio of omega-6 to omega-3 essential fatty acids (EFA) of ~1 whereas in Western diets the ratio is 15/1 – 16.7/1. Western diets are deficient in omega-3 fatty acids, and have excessive amounts of omega-6 fatty acids compared with the diet on which human beings evolved and their genetic patterns were established. Excessive amounts of omega-6 polyunsaturated fatty acids (PUFA) and a very high omega-6/omega-3 ratio, as is found in today’s Western diets, promote the pathogenesis of many diseases, including cardiovascular disease, obesity, diabetes, cancer, inflammatory and autoimmune diseases, and mental health, whereas increased levels of omega-3 PUFA (a lower ...omega-6/omega-3 ratio), exert beneficial effects. Studies on the mechanisms involved indicate that linoleic acid (LA) increases low-density lipoprotein oxidation and severity of coronary atherosclerosis and inhibits eicosapentaenoic acid (EPA) incorporation in the neutrophil membrane phospholipids of human subjects. Furthermore, decreasing LA with constant alpha-linolenic acid (ALA) in dietary fats increases EPA in plasma phospholipids in healthy men. In healthy subjects on a modified Mediterranean diet, lowering the omega-6/omega-3 ratio decreases vascular endothelial growth factor (VEGF), platelet activation, and tumor necrosis factor alpha (TNF-α), but increases adiponectin significantly as well as fatty acid oxidation. In transgenic animals the balanced omega-6/omega-3 fatty acid ratio decreases the risk for chronic diseases. Omega-3 fatty acids influence gene expression. Genetic variants in the 5-lipoxygenase gene promoter can trigger atherogenesis in humans at higher intake of omega-6 fatty acids whereas the effect of the gene variant is blunted in the presence of a high EPA and docosahexaenoic acid (DHA) dietary intake. A lower omega-6/omega-3 ratio is associated with decreased risk of many chronic diseases including cardiovascular disease, hypertension, arthritis, osteoporosis, cancer, neurodegenerative diseases, and various aspects of mental illness, violent behavior, and deficient cognition in both children and the elderly. The balance of omega-6 and omega-3 fatty acids is important for homeostasis and normal development throughout the life cycle. Because many chronic diseases are multigenic and multifactorial the therapeutic dose of omega-3 fatty acids will depend on the degree of severity of disease resulting from the genetic predisposition. The scientific basis for the development of public policy to develop dietary recommendations, including a balanced omega-6/omega-3 ratio, is robust.

Adrenal fatigue is a very common problem in our society today. However, it can present in many ways and has been called by many different labels. We will review the common presenting complaints, physical exam findings, appropriate laboratory work-up and treatment of adrenal fatigue. The critical analysis and prioritization of laboratory testing to acquire objective data on adrenal function will be discussed. In addition, we will learn to utilize diet, nutrients, phytonutrients, and hormone replacement to enhance adrenal function.

Endothelium, Erection and Coronary Arteries: the dilemma of the ageing male


Twenty five years ago we have clearly establish that erectile dysfunction (ED) was frequently linked to vascular risk factors ‘VRF) and that more VRF were present more likely ED will have an arterial origin. Thus ageing males smokers, obese, diabetics, suffering hypertension and/or excess of lipids are prone to have ED. Due to the particular hemodynamic of the penis needing to achieve quickly at the right moment full rigidity, even a very light reduction of the caliber of these small arteries shall reduce the amount of blood reaching the organ and cause ED. Obviously ED in patients with VRF or metabolic syndrome is an alarm symptom for further vascular diseases, namely coronary heart disease (CHD). We shall show how ED and CHD are twins and that early markers of the endothelium help to ...determine those who are at risk. By evaluating endothelial dysfunction soon when still reversible, we may prevent the evolution of this population from entering in the arteriosclerosis disease. This applies to the entire ageing population and even the younger one submitted to all the risks factors of the modern civilization.

Since the human genome sequence was deciphered, millions of genetic variations have been discovered and catalogued. Based on the common variant-common disease hypothesis, hundreds of thousands of genetic variants have been screened for their association with common chronic and complex diseases. In the past 2 years, a large number of genome wide association studies supported by advances in massive parallel genotyping have made it possible to provide more than 70 diseases susceptibility loci for several common diseases such as diabetes and cardiovascular diseases. 
However, translating these results into improved clinical diagnostic management still remains a challenge because of the complexity of the genetic factors underlying these diseases and the overwhelming environmental and lifestyle influences.
A large proportion of these disorders have been related to an oxidative stress increase and ...recent research has suggested a direct link between the predisposition to a disease such as prostate cancer, the SOD2 V16A genetic variation and oxidative stress (Kang D. et al., 2007). In this particular case, a precise measurement of oxidative stress can advantageously complement a genetic screening for this particular SNP and provide it with an enhanced risk assessment for prostate cancer. 
My research focus in the development of genetic test panels using the latest technological genotyping innovations. We therefore propose, in partnership with Edel Therapeutics - which has developed a new patented device for measuring the antioxidant capacity of biological fluids based on electron transfer - to combine genetic testing and the antioxidant capacity measurement as a new validation and research tool for oxidative stress related diseases. Such a multi-level approach will pave the way for the understanding of the interaction between genetic variation- oxidative stress - related diseases and a more accurate personalized medicine.

Promession

The conceptual idea is to combine biological knowledge with a dignified and ethically correct way of being remembered by ones next of kin. The primary principles are preservation after death in organic form and shallow burial in living soil that quickly converts us to mulch.

The fact that this way of thinking is contrary to many customs, yet we should try to adopt a more natural approach to our life and our death. Today`s burial traditions conceal reality from people and do not allow them to feel secure in the fact that death is essential to new life. 

 Deeper insights in ecology provide greater understanding of and respect for life on earth. With the knowledge of what happens to the body after death, it is Promessas hope that people will find greater security in their physical fate. This, in turn, can give our minds greater freedom to ponder the spiritual issues ...that we all carry within ourselves.