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Objectives: 1. Understanding of the intimate relationship between skin and gut, via the regulation of the peripheral sympathetic nerve system, in particular by the activity of the vagus nerve.
2. Skin appears to be in close relationship with the gut microbiota. Modifications in the latter may result in (or be a consequence of) gut barrier dysfunction, due to cortisol overactivity, when the central nervous system, with its rewards program cannot cope any longer with stress.

Introduction: The central nervous system and its peripheral brains, one in the skin and one in the gut, are modulated by the ortho and parasympathetic systems, in particular by the activity of the vagus nerve. The strategic gut-brain axis is linked to the complex and selective network of microbiota, present in all body areas. Cortisol overactivity, due to stress, will give induce a 3-ways conversation between the brain, gut and skin, alterations/improvements of which (notably via psychobiotics) become most visible through skin radiance/dullness, firmness/wrinkles or pigmentation.

Materials / method: Several studies indicate that stress-induced disruption of skin and gut barriers leads to premature senescence. Human and animal epidermal and dermal endothelial cells have been studied for the expression of adhesion molecules, elicited either by pro-inflammatory cytokines or by mechanical stressors. In several gut models, from in vitro enterocyte cultures to rodent and human studies, the link between modifications of the intestinal microbiota upon anti-inflammatory treatment has been demonstrated.

Results: Preservation of the skin’s resident flora is thought to be an effective way to maintain “normal” skin functions. The skin reacts to pro-inflammatory and/or mechanical stresses by enhancing repair processes associated to an intense neo vascularization. Our results show a less intense repair activity and restoration as well as a more youthful skin. In the gut, modulation of the balance of microbiota strains (Clostridii vs coliforms), induced by a non-toxic anti-inflammatory treatment, is associated to a concomitant barrier restoration, preventing generalization of the inflammatory process.

Conclusion: In skin and gut, the protective barriers associated to a fully functional microbiota counteract the inflammation induced by stress, toxins or infections. Microbiota, barrier function and immune system are closely interdependent and federated. Psychobiotics have been shown to reduce the consequences of the stress-induced “leaky gut”, whereas oral administration of probiotic bacteria may represent a novel approach to protect the skin’s immune system against accelerated aging. Altogether, if dysbiosis-dependent systemic inflammation is affecting organs, skin is its first visible reflection.

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Objectives: ,,The aggregation of marginal gains,, was developed by Dave Brailsford, the trainer which changed the British Cycling Team and dominated the Olympic Games in Beijing and London, and Tour de France.

“The aggregation of marginal gains” represent the philosophy of searching for a tiny margin of improvement in everything we do, and give fantastic results over time.

During the ten-year span from 2007 to 2017, British cyclists won 178 world championships and 66 Olympic or Paralympic gold medals and captured 5 Tour de France victories in what is widely regarded as the most successful run.

Introduction: Ageing is a process in which both intrinsic and extrinsic determinants lead progressively to a loss of structural integrity and physiological function.

Intrinsic ageing of the skin occurs inevitably as a natural consequence of physiological changes over time at variable yet inalterable genetically determined rates.

Extrinsic factors are, to varying degrees, controllable and include exposure to sunlight, pollution or nicotine, repetitive muscle movements, and miscellaneous lifestyle components such as diet (especially sugar), sleeping position and overall health.

Materials / method: The face is the primary source of information in social perception, and facial cues to health can be divided into two broad classes: facial shape, linked to previous health and is relatively fixed and facial colouration, reflecting current health.

Skin texture studies have shown that the effects of skin color distribution can account for up to 20 years of perceived age.

Aging signs can be classified into four main categories: wrinkles/texture, lack of firmness of cutaneous tissues (ptosis), vascular disorders, and
pigmentation heterogeneities.

Results: The approach of ageing in this moment reflect both the main complaining of the patient (wrinkles, texture, laxity etc.) and the possibilities of ,,turn back the clock,, of the moment (respectively laser and EBD, surgery and hormonal approach etc.)

The idea is that we don't have to make a huge change overnight, especially in anti ageing medicine, BUT improve with 1% in everything - skin care, diet (cutting sugar), sleep, reducing the stress, fillers and toxins, laser and surgery etc., AND we will have amazing results.

Conclusion: Aging is a complex process in all human societies reflecting biological, environmental, and genetic influences. It is multidimensional, comprising physical, psychological, and social change that is also influenced by cultural and societal standards.

Dave Brailsford - change the history of cycling by making small adjustments and search for 1% improvement in everything.

In anti ageing medicine ,,aggregation of marginal gains” is a New Concept and is important to highlight that everything count and we must treat our body in an holistic and integrative way, and to take care about life style.

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Objectives: The objective of this study was to review changes that occur with intrinsic and extrinsic aging, and provide evidence-based holistic counseling recommendations that can be used synergistically with aes- thetic procedures to maximize antiaging interventions.

Introduction: Aging is a multifactorial process and depends on both intrinsic and extrinsic factors. Procedural options for diminishing signs of intrinsic aging and cosmetic rejuvenation have expanded dramatically. However, less attention is paid to counseling patients on options for mitigating extrinsic factors related to aging.

Materials / method: A PubMed search was conducted for articles on intrinsic and extrinsic aging as it relates to skin, fat, muscle, and bone. Key clinical trials and studies on the effect of diet, hormones, exercise, sleep, stress, dental hygiene, smoking, pollution, and oxidative stress on the aging process are reviewed, and treatment recommendations are summarized based on available evidence.

Results: Conventional cosmetic procedures and cosmeceuticals work together with nutritious diet, exer- cise, dental hygiene, hormonal balance, stress reduction, smoking and pollution avoidance, and healthy sleep patterns for a better effect on antiaging.

Conclusion: A combination approach of multiple nonsurgical modalities along with healthy lifestyle recom- mendations to minimize intrinsic and extrinsic aging factors allows cosmetic practitioners to target multiple facets of aging concurrently and maximize the aesthetic interventions cosmetic dermatologists/practitioners provide.

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Objectives: Aging is one of the most unknown process. But understanding of some important moments of this process gives us the possibility to slow it.

Introduction: We decide to make the analysis of the processes that are going in the skin with age and ways of influence on them

Materials / method: Group of patients in the age 40-60
Medical device - roller combined with different chemical agents
Visual instruments of measurement: Visia, colorimeter, etc

Results: We have found that after a series of procedures the visible condition of the skin start to be like in the younger age

Conclusion: It is possible to make skin look younger but to do it in the right way it is necessary to understand the principles of aging process

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Objectives: The skin and skin ageing | A journey to the depths of the skin | The epidermis | The dermis and protein fibres | The hypodermis | Men's skin: its differences

Introduction: Cell renewal or the keratinisation process. The epidermis is in a constant state of renewal. In the basal layer, the keratinocytes are produced and then divide into two identical cells. One will remain in place and continue to divide, while the other will gradually migrate up to the horned layer - the external and visible part of the epidermis. This is the differentiation process. At the end of this migration, the keratinocytes unlodge the corneoctyes (= keratinocyte that has lost its nucleus), which are then shed as squames. This shedding phenomenon known as desquamation is the final stage

Materials / method: Composition of the Dermis

It is largely made up of:

Fibroblasts: the predominant cells in the dermis. They synthesize the collagen, elastin and glycoprotein structural fibres. The destruction of these fibres automatically occurs with age. Their numbers drop by half between the ages of 20 and 80.

Collagen: inelastic fibre and principle structural protein. It is the predominant component of connective tissue and provides support for surrounding tissue. It gives the skin its resilience and firmness. Collagen fibres trap water and thus contribute to the skin's hydration.

Results: The hypodermis is the skin's energy reserve. It is composed of loose connective tissue known as white adipose tissue. This, in turn, is made up of cells known as adipocytes that are programmed to store fatty acids. They are clumped together with the papillae adiposae and separated by fibrous walls of collagen and elastin. Like a mattress, the hypodermis helps give the skin its plasticity, acting as a shock absorber and heat insulator. Its thickness varies depending on the individual and the area of the body in question.

Conclusion: The main difference between male and female skin is that they depend on different hormonal systems, which in turn has a fundamental effect on their metabolism.
The following characteristics are also notable:
Male skin is about 24% thicker than female skin.
It secretes a thicker and more durable hydrolipidic film.
The pores are more dilated.
Its structure is rougher and more resilient.
It has more hair growth.

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Objectives: In the last decade clinical manifestations of skin diseases have changed significantly,which is supported by modern technologies,in particular the Internet.Unlike other fields of medicine,patients with skin pathology use the internet for self-diagnosing and self-treatment.As a result,we get altered skin pathologies,which are difficult to further diagnose and treat.

Introduction: Such clinical case was in 2017-2019, 112 patients of both sexes aged 18 to 65 years,out of which 99.1% were 18 to 34 years old.

Materials / method: Clinical cases of diseases: Tinea of the face,Psoriasis of the face,Molluscum contagiosum,Discoid lupus erythematosus,Herpes simplex,Rosacea,Lupus vulgaris.

Results: Such cases can be called an alteration of the disease and complication caused by the Internet.

Conclusion: In order to avoid such complications access to the spread of medical information should be changed;Patient should obtain the information only through the appropriate website developed by medical associations.

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这项工作没有任何直接或间接的资金支持。由作者自己承担责任。 Title: Influence of the Internet on alteration of the clinical picture of skin diseases

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