An Update on the Clinical Efficacy and Safety of Collagen Injectables for Aesthetic and Regenerative Medicine Applications.

Soft tissues diseases significantly affect patients quality of life and usually require targeted, costly and sometimes constant interventions. With the average lifetime increase, a proportional increase of age-related soft tissues diseases has been witnessed. Due to this, the last two decades have seen a tremendous demand for minimally invasive one-step resolutive procedures. Intensive scientific and industrial research has led to the recognition of injectable formulations as a new advantageous approach in the management of complex diseases that are challenging to treat with conventional strategies. Among them, collagen-based products are revealed to be one of the most promising among bioactive biomaterials-based formulations. Collagen is the most abundant structural protein of vertebrate connective tissues and, because of its structural and non-structural role, is one of the most widely used multifunctional biomaterials in the health-related sectors, including medical care and cosmetics. Indeed, collagen-based formulations are historically considered as the "gold standard" and from 1981 have been paving the way for the development of a new generation of fillers. A huge number of collagen-based injectable products have been approved worldwide for clinical use and have routinely been introduced in many clinical settings for both aesthetic and regenerative surgery. In this context, this review article aims to be an update on the clinical outcomes of approved collagen-based injectables for both aesthetic and regenerative medicine of the last 20 years with an in-depth focus on their safety and effectiveness for the treatment of diseases of the integumental, gastrointestinal, musculoskeletal, and urogenital apparatus.

Take a picture! The role of visual methods in understanding psychiatric patient's everyday life.

BACKGROUND AND AIM: Understanding the patient's experience of mental illness can foster better support for this population and greater partnership with healthcare professionals. This study aims to explore the application of visual methods in the psychiatric field and, in particular, the experience of people suffering from psychotic disorders because it is still an open question that has not been only partially empirically examined. METHODS: This qualitative study was conducted using two visual methods (auto-photography and photo-elicitation) associated with the narrative that emerged from an unstructured interview, in a clinical setting of adult Mental Health in Italy, between October 2019 and February 2020. A total of 5 patients and 5 corresponding referring healthcare professionals were identified and enrolled.  Patients were asked to produce photographs following 4 thematic areas: "Fun", "Time", "Something indispensable", "Place where I feel good". RESULTS: A total of 85 photographs were produced. Visual methods have proved to be a useful technique in qualitative research in the area of adult psychiatry. From the interviews, it emerged that visual methods have allowed psychotic patients to use a new language to be able to communicate their emotions. CONCLUSIONS: The healthcare professionals involved also confirm the potential of this tool which, when combined with the traditional interview, is able to deepen the patient's knowledge by overcoming the verbal barriers that often make it difficult to reconstruct the individual experience of illness.

[Psychotherapy of borderline personality disorder: critical factors and proposals of intervention]. / La psicoterapia del disturbo borderline di personalità: aspetti critici e proposte terapeutiche.

Borderline personality disorder (BPD) represents a significant therapeutic challenge. Critical factors in psychotherapeutic treatment of patients with BPD are noticeable and strictly related to the psychopathological dimensions of this disorder: affective and relational instability, behavioral impulsivity and precarious definition of identity. These features are emphasized by therapeutic intervention and become evident during the course of the treatment. Psychotherapeutic setting induces BPD patient to actualize the dysfunctional relational patterns that have been acquired during childhood. Specific critical factors concern the characteristics of the patient (risk of suicide, aggressive behaviors, chronic course of the disorder, disorganized attachment style), of the therapist (therapeutic skills, training, countertransference, risk of burnout) and of the setting of psychotherapy (patients selection, therapeutic alliance, need to set limits, duration and end of therapy). In Otto Kernberg's and Marsha Linehan's models of psychotherapy specific for DBP the authors identify substantially overlapping objectives and modalities of intervention. In particular, therapists should take care of patient safety, maintain boundaries of therapeutic setting and promote the development of psychotherapeutic process. The aim of this article is to analyze the main critical factors affecting psychotherapeutic process in patients with BPD. Objectives and priorities that therapist should consider to address these issues will be discussed. We will also try to make clear why interpersonal psychotherapy adapted to DBP can represent one of the therapeutic models that may be useful to manage and resolve these difficulties.