Vincenzo Nobile

Background/Objectives: To describe therapy-associated oral stomatitis and perianal mucosal lesions in pediatric oncohematology patients and compare healing time according to the treatment approach used in routine clinical practice. Methods: This retrospective observational study was conducted at Meyer Children’s Hospital, Florence, Italy. Electronic health records of patients admitted to the Oncology or Bone Marrow Transplantation units between 1 January and 31 December 2024, were screened. Eligible patients were aged 0 to 18 years and had documented oral stomatitis and/or perianal mucosal lesions with sufficient clinical and nursing documentation to determine lesion localization, treatment, clinical evolution, and healing time. Demographic, clinical, pharmacological, nutritional, and nursing variables were extracted. Oral mucositis severity was classified using the World Health Organization Oral Toxicity Scale. Results: Among 525 screened records, 89 eligible patients aged 5 months to 18 years were included in the final analysis. Lesions were distributed across three mutually exclusive categories: oral-only (39.3%), perianal-only (42.7%), and combined oral–perianal involvement (18.0%). Most oral cases were grade 2 to 4. Oral stomatitis treated with Mucosamin^® Spray healed faster than conventional therapy (3.5 ± 0.8 vs. 6.7 ± 1.1 days; mean difference, −3.21 days; 95% CI, −3.75 to −2.67; p < 0.001). Perianal fissures treated with Mucosamin^® Rectal Gel also showed a shorter healing time than conventional therapy (3.4 ± 0.8 vs. 6.1 ± 0.8 days; mean difference, −2.76 days; 95% CI, −3.30 to −2.21; p < 0.001). Conclusions: Mucosamin^® Spray and Rectal Gel were associated with shorter documented healing times than conventional approaches in this real-world pediatric cohort. These findings should be interpreted as preliminary and confirmed in controlled prospective multicenter studies.

Genetic factors, dietary habits, and lifestyle may influence individual responses to supplementation, including the bergamot flavanones naringin and naringenin, which are implicated in lipid modulation. The aim of this double-blind, placebo-controlled clinical trial (RCT) is to assess the effects of the supplementation for four months of a standardised bergamot extract at the dosage of 375 mg/day, providing 150 mg/day of flavonoids, on lipid parameters of 108 East Asian adults with LDL-Cholesterol (LDL-C) 100– 159 mg/day, since to date, the RCTs have been conducted on Caucasian subjects only. After 4 months, total Cholesterol and LDL-C decreased (− 7.3% and − 7.0%) with no clinically relevant safety changes regarding hepatic/renal biochemistry, weight, and blood pressure.

Background/Objectives: Diabetes is associated with impaired wound healing, with consequences for tissue recovery across surgical procedures. In the oral context, hyaluronic acid-based adjunctive therapies have shown promise in improving early post-extraction healing in diabetes; however, clinical evidence remains limited. Different supplemented HA-based formulations yield heterogenous healing outcomes. Moreover, whether age or diabetes duration influences the effect of these adjunctive therapies remains to be established. Methods: We conducted an individual-participant-data pooled analysis of two randomized controlled trials that evaluated the use of hyaluronic acid supplemented with two different sets of selected amino acids; individual data from each trial was combined into a single dataset. Results: In this pooled analysis, modified healing index scores improved significantly over time. When each intervention was evaluated relative to its corresponding control, hyaluronic acid plus six pro-collagen synthesis amino acids produced a significantly greater improvement in healing response over time than the other HA-based formulation, after adjustment for age (Greenhouse–Geisser: time × treatment: F = 5.821, p < 0.001) and diabetes duration (Greenhouse–Geisser: time × treatment: F = 4.939, p < 0.001). Neither age nor diabetes duration significantly modified the healing trajectory (Greenhouse–Geisser: time × age: F = 2.536, p = 0.083; time × diabetes duration: F = 0.131, p = 0.878). No clear association with age or diabetes duration was observed. Conclusions: Supplementing hyaluronic acid with six selected amino acids associated with a significantly faster post-extraction tissue recovery in patients with diabetes. Moreover, treatment choice was relevant regardless of age or years since diabetes diagnosis.

Background: Skin aging is influenced by intrinsic and extrinsic factors, and growing evidence suggests that nutritional interventions, particularly probiotics, may modulate key biological pathways involved in skin barrier function, hydration, and oxidative stress through the gut–skin axis. Methods: In this randomized, double-blind, placebo-controlled clinical trial, 66 adults received a probiotic formulation containing Lacticaseibacillus rhamnosus LRH020, Lactiplantibacillus plantarum PBS067, and Limosilactobacillus reuteri PBS072 for 56 days, followed by a 28-day follow-up. Skin structure, function, and oxidative status were assessed using 3D profilometry, high-frequency ultrasound, corneometry, transepidermal water loss (TEWL), FRAP assay, and expert clinical scoring. Results: Compared with placebo, the probiotic group showed significant improvements in wrinkle depth (−15.0% at T56), and roughness (−6.1% at T56). Moreover, other skin parameters were significantly enhanced by the end of treatment, including greater skin density, hydration, and antioxidant capacity, alongside a reduction in TEWL. Improvements persisted at follow-up, suggesting a durable, lasting benefit of the probiotic formulation beyond the treatment period. Conclusions: These findings support the role of targeted probiotic supplementation as a promising strategy to improve structural, functional, and oxidative markers of skin aging.

Intrinsic and extrinsic factors compromise skin barrier function and dermal density over time. While Brassica vegetables are known for their bioactive glucosinolates, clinical data regarding their specific effects on skin structure are limited. This prospective, open-label exploratory study evaluated the anti-aging efficacy of Purebkale™, a Brassica oleracea dry aqueous extract. Fifty healthy women with mild-to-moderate signs of aging ingested the supplement daily for 56 days. Instrumental assessments included transepidermal water loss (TEWL), stratum corneum cohesivity (protein content), skin firmness, elasticity, wrinkle depth, and dermis density. This study met its primary objectives, indicating a significant improvement in barrier function: TEWL decreased by 7.5% and protein removal via tape-stripping was reduced by 27.8% (p < 0.001). Furthermore, dermal density increased by 12.8%, while wrinkle depth was reduced by 15.1%. Biomechanical parameters also showed significant improvements, with firmness increasing by 17.4% and elasticity by 9.7%. Although oxidative stress markers remained stable, participants’ self-assessments reported high satisfaction with skin quality. These findings suggest that oral supplementation with Brassica oleracea extract effectively supports skin barrier integrity and dermal structure, offering a viable healthy aging strategy for skin.

Background/Objectives: Conventional wound care often fails to address the complex pathology of diabetic wounds adequately. Research shows that hyaluronic acid and its derivatives promote tissue regeneration in the later stages of wound healing. We evaluated the efficacy of a novel topical formulation in promoting socket healing following post-extraction in patients with type-2 diabetes mellitus, by combining sodium hyaluronate and six amino acids involved in collagen synthesis. Methods: A single-center, two-arm randomized controlled trial was conducted in adults aged 18 and over with type 2 diabetes requiring extraction of at least one non-impacted tooth. Forty-four participants were randomized to receive either the intervention or no treatment. Primary outcomes included a modified Landry’s healing index and rate of socket closure. Results: Comparative analysis showed significantly improved healing index scores in the intervention group by day 7 and day 14 compared to control, with no improvements in the rate of socket closure. Conclusions: This research provides evidence on the therapeutic efficacy of the gel formulation under study in promoting wound healing of post-extraction sites in diabetic patients undergoing tooth extraction. Further research is needed to compare its efficacy with standard treatments and adjunct therapies.

Oily skin is a prevalent dermatological condition characterized by excessive sebum production, due to hyperactivity of the sebaceous glands. In this study, a randomized split-face clinical trial was conducted on 22 subjects with combination to oily skin to evaluate the efficacy of a cosmetic cream containing a standardized amount of isorhamnetin extract from prickly pear (Opuntia ficus-indica), applied twice daily over a 28-day period. Efficacy assessments included instrumental measurements of skin sebum content, Sebum Excretion Rate (SER), pore size, tumor necrosis factor-alpha (TNF-α) levels, skin microbiome composition, and lipid profile. Additionally, the study included an assessment of participants’ subjective perception. After 14 and 28 days of product use, respectively, a significant reduction in skin sebum content was observed, with decreases of 13.1% and 21.1% on the forehead, and 10.4% and 15.8% in the alar groove. This reduction in sebum levels was associated with a mattifying effect lasting up to 7.1 h, a 37.2% decrease in the sebum excretion rate (SER), and a 9.6% reduction in pore size. The TNF- α levels decreased by 7.4%. The extract was well tolerated by the skin microbiome, which remained stable. Additionally, analysis of the skin lipid profile revealed an increase in both ceramide and triacylglycerol levels. Overall, our findings demonstrate the role of the extract in modulating sebaceous gland activity, improving skin appearance, reducing inflammation, and supporting barrier integrity and hydration in individuals with oily skin.

Edematous fibrosclerotic panniculopathy (EFP) affects ∼80% to 98% of postpubertal women and has a significant impact on quality of life. Its unclear etiopathology and the multifactorial origin pose a significant challenge for its clinical management. This study aimed to evaluate the efficacy and the safety of a commercially available mixture of hyaluronic acid and amino acids in an alkaline solution. A prospective multicenter clinical trial was carried out on 46 women with EFP Stage I to early Stage IV. The improvement of cellulite severity was evaluated by the modified Clinician-Reported Photonumeric Cellulite Severity Scale (CR-PCSS) and the modified Patient-Reported PCSS (PR-PCSS) before the first (T1), the second (T2), and the third injection (T3) and after 3 (T4) and 6 (T5) months of treatment. The psychological impact of cellulite was measured using the Objectified Body Consciousness (OBC) scale. The PR-PCSS revealed that 95.3% of participants reported an improvement in their appearance. These positive outcomes remained consistent up to 6 months following the initial treatment. Similarly, the CR-PCSS showed that as early as 2 weeks after the first treatment, 76.7% of participants demonstrated objective improvement based on the Global Aesthetic Improvement Scale. These improvements also remained stable for up to 6 months. Self-esteem (OBC scale) was improved. No major adverse events were reported; minor bruising occurred as expected because of injections. Sunekos Cell 15 is a possibly effective and well-tolerated treatment for cellulite, particularly in cases with pronounced fibrosis, potentially offering a minimally invasive therapeutic option. Level of Evidence: 4 (Therapeutic) For image description, please refer to the figure legend and surrounding text.

Skin is constantly exposed to UV radiation. While topical sunscreens are the main preventative measure, oral photoprotective agents are emerging as promising systemic adjuncts, offering uniform, continuous protection. This study presents the results of two clinical trials designed to evaluate the efficacy of supplementation with a standardized coriander (Coriandrum sativum L.) seed oil (CSO) in mitigating UV-induced skin damage, in comparison with a placebo. The first trial investigated the effects of CSO supplementation on women with reactive skin, assessing UVA+B-induced skin erythema and tumor necrosis factor-alpha (TNF-α) release. The second trial included women of all skin types and, in addition to the outcomes mentioned above, examined UVA-induced lipoperoxidation. Measurements were taken before and after 56 days of supplementation. CSO supplementation led to a significant reduction in UV-induced skin erythema and associated TNF-α levels in both cohorts, with decreases of 11.8% and 24.1% in the reactive skin group and 18.1% and 18.7% in the cohort with all skin types, respectively. In women of all skin types, UV-induced skin lipoperoxidation was reduced by 31.9% at 4 h and by 69.9% at 24 h post-exposure. To the best of our knowledge, this is the first study reporting the photoprotective efficacy of CSO. This finding is attributed to CSO’s high petroselinic acid content and its known anti-inflammatory properties.

Background/Objectives: Conventional wound care often fails to address the complex pathology of diabetic wounds adequately. Research shows that hyaluronic acid and its derivatives, while promoting tissue regeneration and healing in later stages. We evaluated the efficacy of a novel topical formulation in promoting socket healing following post-extraction in patients with type-2 diabetes mellitus, by combining sodium hyaluronate and six amino acids involved in collagen synthesis. Methods: A single-center, two-arm randomized controlled trial was conducted in adults aged 18 and over with type 2 diabetes requiring extraction of at least one non-impacted tooth. Forty-three participants were randomized to receive either the intervention or no treatment. Primary outcomes included a modified Landry’s healing index and rate of socket closure. Results: Comparative analysis of healing index scores showed significantly improved healing in the intervention by day 7 and day 14 compared to control, with no improvements in the rate of socket closure in the treatment cohort. Conclusions: This research provides evidence on the therapeutic efficacy of the gel formulation under study in promoting wound healing of post-extraction sites in diabetic patients undergoing tooth extraction. Further research is needed to compare its efficacy with standard treatments and adjunct therapies.