Dermatología en Costa Rica

Saturday, September 28, 2019

Itraconazole for BCC: Does it work? | MDedge Internal Medicine

Itraconazole for BCC: Does it work? | MDedge Internal Medicine

Itraconazole for BCC: Does it work?

EXPERT ANALYSIS FROM THE ACMS ANNUAL MEETING

Oral itraconazole shows potential for treatment of locally advanced or metastatic basal cell carcinoma (BCC) as well as Gorlin syndrome, Justin J. Leitenberger, MD, declared at the annual meeting of the American College of Mohs Surgery.

The oral antifungal inhibits the hedgehog signaling pathway, a key driver of BCC. And while itraconazole is not as potent an inhibitor of hedgehog pathway expression as, say vismodegib (Erivedge), the antifungal acts at a separate site on the pathway, making it an attractive candidate for combination therapy, explained Dr. Leitenberger of Oregon Health & Science University, Portland.

Dermatologists at Stanford University have led the way in exploring oral itraconazole as a treatment for BCC. Among a series of 29 patients with one or more large but nonadvanced BCCs, 19 were treated using oral itraconazole at 200 mg b.i.d. for 1 month or 100 mg b.i.d. for an average of 2.3 months. Hedgehog pathway expression was reduced by 65% in the itraconazole-treated patients, as compared with the 90% reduction which is achieved with vismodegib.

Of more direct clinical relevance, however, itraconazole also reduced tumor area by 24%. Four of eight patients with 57 tumors achieved a partial response, and the other four had stable disease (J Clin Oncol. 2014 Mar 10;32[8]:745-51).

The Stanford group has also shown that combination therapy with oral itraconazole and intravenous arsenic trioxide reduces hedgehog pathway expression by 75%, up by an absolute 10% from itraconazole alone. The two agents inhibit the pathway at different sites.

Five patients with metastatic BCC who relapsed after treatment with vismodegib received intravenous arsenic trioxide for the first 5 days of every month, followed by oral itraconazole at 200 mg b.i.d. on days 6-28. Three patients completed three such cycles, while two discontinued early because of progressive disease or adverse events including a grade 3 infection and grade 2 transaminitis. All three patients who completed three treatment cycles achieved stable disease. The Stanford investigators speculated that concurrent continuous dosing might be required to obtain tumor shrinkage (JAMA Dermatol. 2016 Apr;152[4]:452-6).

Lots more work remains to be done in order to optimize combination therapy utilizing oral itraconazole for advanced BCC. Different dosing regimens and combinations of hedgehog pathway inhibitors need to be studied. Another important question is how effective itraconazole-based combinations will be in vismodegib-naive as compared with vismodegib-resistant patients, Dr. Leitenberger observed.

He reported having no financial conflicts regarding his presentation.

bjancin@mdedge.com



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Friday, September 27, 2019

Melanoma invasivo Mohs

Study compares Mohs, excision for early invasive melanoma
Patients with Stage I invasive melanoma might have better odds of long-term survival if they undergo Mohs micrographic surgery instead of conventional wide-margin excision, particularly for primary head and neck lesions, according to the results of a retrospective survey published in JAMA Dermatology. Researchers studied data on 70,319 patients in the National Cancer Database, 3,324 of whom received MMS, but they did not have access to data on recurrence or re-excision rates, or on certain high-risk features.
MedPage Today (free registration) (9/25) 

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Agua fria en quemaduras

Shh itraconazol

Itraconazole for BCC: Does it work?

EXPERT ANALYSIS FROM THE ACMS ANNUAL MEETING

– Oral itraconazole shows potential for treatment of locally advanced or metastatic basal cell carcinoma (BCC) as well as Gorlin syndrome, Justin J. Leitenberger, MD, declared at the annual meeting of the American College of Mohs Surgery.

The oral antifungal inhibits the hedgehog signaling pathway, a key driver of BCC. And while itraconazole is not as potent an inhibitor of hedgehog pathway expression as, say vismodegib (Erivedge), the antifungal acts at a separate site on the pathway, making it an attractive candidate for combination therapy, explained Dr. Leitenberger of Oregon Health & Science University, Portland.

Dermatologists at Stanford University have led the way in exploring oral itraconazole as a treatment for BCC. Among a series of 29 patients with one or more large but nonadvanced BCCs, 19 were treated using oral itraconazole at 200 mg b.i.d. for 1 month or 100 mg b.i.d. for an average of 2.3 months. Hedgehog pathway expression was reduced by 65% in the itraconazole-treated patients, as compared with the 90% reduction which is achieved with vismodegib.

Of more direct clinical relevance, however, itraconazole also reduced tumor area by 24%. Four of eight patients with 57 tumors achieved a partial response, and the other four had stable disease (J Clin Oncol. 2014 Mar 10;32[8]:745-51).

The Stanford group has also shown that combination therapy with oral itraconazole and intravenous arsenic trioxide reduces hedgehog pathway expression by 75%, up by an absolute 10% from itraconazole alone. The two agents inhibit the pathway at different sites.

Five patients with metastatic BCC who relapsed after treatment with vismodegib received intravenous arsenic trioxide for the first 5 days of every month, followed by oral itraconazole at 200 mg b.i.d. on days 6-28. Three patients completed three such cycles, while two discontinued early because of progressive disease or adverse events including a grade 3 infection and grade 2 transaminitis. All three patients who completed three treatment cycles achieved stable disease. The Stanford investigators speculated that concurrent continuous dosing might be required to obtain tumor shrinkage (JAMA Dermatol. 2016 Apr;152[4]:452-6).

Lots more work remains to be done in order to optimize combination therapy utilizing oral itraconazole for advanced BCC. Different dosing regimens and combinations of hedgehog pathway inhibitors need to be studied. Another important question is how effective itraconazole-based combinations will be in vismodegib-naive as compared with vismodegib-resistant patients, Dr. Leitenberger observed.

He reported having no financial conflicts regarding his presentation.

bjancin@mdedge.com


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Dabrafenib Plus Trametinib in Metastatic Melanoma

Published in Dermatology and 

Journal Scan / Research · July 04, 2019

Dabrafenib Plus Trametinib in Metastatic Melanoma

The New England Journal of Medicine

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Abstract 

BACKGROUND

Patients who have unresectable or metastatic melanoma with a BRAF V600E or V600K mutation have prolonged progression-free survival and overall survival when receiving treatment with BRAF inhibitors plus MEK inhibitors. However, long-term clinical outcomes in these patients remain undefined. To determine 5-year survival rates and clinical characteristics of the patients with durable benefit, we sought to review long-term data from randomized trials of combination therapy with BRAF and MEK inhibitors.

METHODS

We analyzed pooled extended-survival data from two trials involving previously untreated patients who had received BRAF inhibitor dabrafenib (at a dose of 150 mg twice daily) plus MEK inhibitor trametinib (2 mg once daily) in the COMBI-d and COMBI-v trials. The median duration of follow-up was 22 months (range, 0 to 76). The primary end points in the COMBI-d and COMBI-v trials were progression-free survival and overall survival, respectively.

RESULTS

A total of 563 patients were randomly assigned to receive dabrafenib plus trametinib (211 in the COMBI-d trial and 352 in the COMBI-v trial). The progression-free survival rates were 21% (95% confidence interval [CI], 17 to 24) at 4 years and 19% (95% CI, 15 to 22) at 5 years. The overall survival rates were 37% (95% CI, 33 to 42) at 4 years and 34% (95% CI, 30 to 38) at 5 years. In multivariate analysis, several baseline factors (e.g., performance status, age, sex, number of organ sites with metastasis, and lactate dehydrogenase level) were significantly associated with both progression-free survival and overall survival. A complete response occurred in 109 patients (19%) and was associated with an improved long-term outcome, with an overall survival rate of 71% (95% CI, 62 to 79) at 5 years.

CONCLUSIONS

First-line treatment with dabrafenib plus trametinib led to long-term benefit in approximately one third of the patients who had unresectable or metastatic melanoma with a BRAF V600E or V600K mutation.


The New England Journal of Medicine
Five-Year Outcomes With Dabrafenib Plus Trametinib in Metastatic Melanoma
N. Engl. J. Med 2019 Jun 04;[EPub Ahead of Print], C Robert, JJ Grob, D Stroyakovskiy, B Karaszewska, A Hauschild, E Levchenko, V Chiarion Sileni, J Schachter, C Garbe, I Bondarenko, H Gogas, M Mandalá, JBAG Haanen, C Lebbé, A Mackiewicz, P Rutkowski, PD Nathan, A Ribas, MA Davies, KT Flaherty, P Burgess, M Tan, E Gasal, M Voi, D Schadendorf, GV Long 

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Wednesday, September 25, 2019

Reuters Asks Judge to Release Secret Propecia Documents

Reuters Asks Judge to Release Secret Propecia Documents

By Dan Levine

September 16, 2019

     
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SAN FRANCISCO (Reuters) - Reuters asked a U.S. judge on Thursday to unseal documents filed in court regarding potential risks associated with Propecia (finasteride), Merck & Co's popular baldness drug.

The motion was filed in federal court in Brooklyn, New York, after a Reuters article on Wednesday revealed accusations that Merck did not fully disclose on Propecia's label the incidence and duration of sexual dysfunction in men who took Propecia in clinical trials. Those allegations are contained in court filings that had been intended to be filed under seal. Read the Reuters report https://www.reuters.com/investigates/special-report/usa-courts-secrecy-propecia/

Federal District Judge Brian Cogan has allowed Merck to keep secret internal company documents in litigation brought by Propecia users against the company. A faulty redaction allowed Reuters to view some of the details in a plaintiff's brief, but the underlying Merck documents cited in that brief are still sealed. Those are the documents the Reuters motion seeks to make public.

"This is a case of tremendous importance that has been sealed without on-the-record findings explaining that sealing," Reuters argued in its motion to intervene in the case. "The First Amendment precludes such an outcome."

Merck did not respond to a request for comment. The company previously told Reuters it "stands behind the safety and efficacy of Propecia" and noted that the drug has been prescribed safely to millions of men since the late 1990s.

A June 25 Reuters investigation revealed how judges have allowed the makers of dozens of consumer products to file under seal in their courts information that is pertinent to public health and safety. They often do so without explanation, though in most jurisdictions, they are required to provide one. Read the Reuters investigation https://www.reuters.com/investigates/special-report/usa-courts-secrecy-judges/

The investigation found that hundreds of thousands of Americans have been killed or seriously injured over the past couple of decades by allegedly defective products -- drugs, cars, medical devices and other products -- while evidence that could have alerted consumers and regulators to potential danger remained under seal.

More than 1,100 Propecia-related lawsuits filed across the U.S. against Merck were consolidated before Judge Cogan in so-called multidistrict litigation (MDL). Merck agreed to settle most of them last year for $4.3 million, to be divided among the plaintiffs.

Prior to the settlement, plaintiffs' lawyers cited internal company communications to allege that in revisions to the drug's original label, Merck understated the number of men who experienced sexual symptoms in clinical trials, and how long those symptoms lasted. Merck settled before responding to the allegation in court.

Under U.S. law, court filings are presumed to be public, and the bar for secrecy is particularly high for the Propecia documents Reuters seeks to unseal, the motion states, because they are essential to plaintiffs' claim that the drug causes persistent sexual side effects.

"These documents should not remain under seal absent the most compelling reasons," Reuters argued.

    https://www.medscape.com/viewarticle/918330


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    Tuesday, September 24, 2019

    Comprar un chicharrón... Abbvie

    Proposed Class-Action Lawsuit Claims Allergan And Other Companies Failed To Disclose Link Between Breast Implants And Rare Cancer

    Bloomberg Law (9/23, Steinberg, Subscription Publication) reports a new proposed class-action lawsuit claims that "Allergan Inc. and related companies failed to disclose a link between breast implants and a rare cancer, and offered an insufficient warranty program to replace recalled implants." The plaintiffs claim Allergan's Biocell silicone textured breast implants increase the risk of breast implant-associated anaplastic large cell lymphoma


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    Friday, September 20, 2019

    Malformaciones vasculares segmentarias faciales

    Journal Scan / Research · September 19, 2019

    Cerebrovascular Anomalies in Children With Segmental Facial Hemangiomas

    The British Journal of Dermatology

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    Abstract 
    The aetiology of infantile haemangiomas is still not fully understood. The hypothesis of tissue hypoxia was corroborated by children presenting with large segmental facial haemangioma (SFH) in association with ipsilateral cerebrovascular and/or cervicovascular (CVA) anomalies. PHACE syndrome (posterior fossa malformations, haemangioma, arterial, cardiac, eye and/or sternal anomalies; OMIM 606519) is diagnosed in about 31% of all children with large facial haemangiomas. Most children have only one extracutaneous manifestation. CVA anomalies were reported in up to 91% of all patients with PHACE. Blood‐flow limiting CVA anomalies confer a risk of arterial ischaemic stroke.2 CVA anomalies are thus the most prevalent and relevant extracutaneous manifestations of PHACE syndrome.

    The British Journal of Dermatology
    Risk of Associated Cerebrovascular Anomalies in Children With Segmental Facial Haemangiomas
    Br J Dermatol 2019 Jun 25;[EPub Ahead of Print], F Schmid, M Reipschlaeger, A Leenen, PH Hoeger 

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    Prurito, ansiedad, depresión e ideas sucidas...

    Itch and Mental Health in Dermatological Patients

    Journal of Investigative Dermatology

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    Abstract 

    Itch is a highly prevalent and multi-dimensional symptom. We aimed to analyze the association between itch and mental health in dermatological patients. This multi-center study is observational cross-sectional conducted in dermatological clinics across 13 European countries. A total of 3530 patients and 1094 healthy controls were included. Patients were examined clinically. Outcome measures were itch (presence, chronicity and intensity), the Hospital Anxiety and Depression Scale, EQ5D-VAS, sociodemographics, suicidal ideation, stress (negative life events and economic difficulties). Ethical approval was obtained. Results showed significant association between the presence of itch in patients and clinical depression, suicidal ideation and economic difficulties (odds ratios respectively OR 1.53 (95% CI 1.15 to 2.02), OR 1.27 (95% CI 1.01 to 1.60), OR 1.24 (95% CI 1.10 to 1.50). The mean score of reported generic health status assessed by the EQ5D-VAS was 65.9 (SD=20.1) in patients with itch, compared to 74.7 (SD= 18.0) in patients without itch, p value < .001 and 74.9 (SD= 15.7) in controls with itch compared to 82.9 (SD= 15.6) in controls without itch, p value <.001. Itch contributes substantially to the psychological disease burden in dermatological patients and the management of patients should include access to multidisciplinary care.

    Journal of Investigative Dermatology
    Itch and Mental Health in Dermatological Patients Across Europe: A Cross Sectional Study in 13 Countries
    J Invest Dermatol 2019 Sep 03;[EPub Ahead of Print], FJ Dalgard, Å Svensson, JA Halvorsen, U Gieler, C Schut, L Tomas-Aragones, L Lien, F Poot, GBE Jemec, L Misery, C Szabo, D Linder, F Sampogna, S Spillekom-van Koulil, F Balieva, JC Szepietowski, A Lvov, SE Marron, IK Altunay, AY Finlay, S Salek, J Kupfer 

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    Melanoma Combi 5 años luego

    Journal Scan / Research · July 04, 2019

    Dabrafenib Plus Trametinib in Metastatic Melanoma

    The New England Journal of Medicine


    TAKE-HOME MESSAGE

    BACKGROUND

    Patients who have unresectable or metastatic melanoma with a BRAF V600E or V600K mutation have prolonged progression-free survival and overall survival when receiving treatment with BRAF inhibitors plus MEK inhibitors. However, long-term clinical outcomes in these patients remain undefined. To determine 5-year survival rates and clinical characteristics of the patients with durable benefit, we sought to review long-term data from randomized trials of combination therapy with BRAF and MEK inhibitors.

    METHODS

    We analyzed pooled extended-survival data from two trials involving previously untreated patients who had received BRAF inhibitor dabrafenib (at a dose of 150 mg twice daily) plus MEK inhibitor trametinib (2 mg once daily) in the COMBI-d and COMBI-v trials. The median duration of follow-up was 22 months (range, 0 to 76). The primary end points in the COMBI-d and COMBI-v trials were progression-free survival and overall survival, respectively.

    RESULTS

    A total of 563 patients were randomly assigned to receive dabrafenib plus trametinib (211 in the COMBI-d trial and 352 in the COMBI-v trial). The progression-free survival rates were 21% (95% confidence interval [CI], 17 to 24) at 4 years and 19% (95% CI, 15 to 22) at 5 years. The overall survival rates were 37% (95% CI, 33 to 42) at 4 years and 34% (95% CI, 30 to 38) at 5 years. In multivariate analysis, several baseline factors (e.g., performance status, age, sex, number of organ sites with metastasis, and lactate dehydrogenase level) were significantly associated with both progression-free survival and overall survival. A complete response occurred in 109 patients (19%) and was associated with an improved long-term outcome, with an overall survival rate of 71% (95% CI, 62 to 79) at 5 years.

    CONCLUSIONS

    First-line treatment with dabrafenib plus trametinib led to long-term benefit in approximately one third of the patients who had unresectable or metastatic melanoma with a BRAF V600E or V600K mutation.


    The New England Journal of Medicine
    Five-Year Outcomes With Dabrafenib Plus Trametinib in Metastatic Melanoma
    N. Engl. J. Med 2019 Jun 04;[EPub Ahead of Print], C Robert, JJ Grob, D Stroyakovskiy, B Karaszewska, A Hauschild, E Levchenko, V Chiarion Sileni, J Schachter, C Garbe, I Bondarenko, H Gogas, M Mandalá, JBAG Haanen, C Lebbé, A Mackiewicz, P Rutkowski, PD Nathan, A Ribas, MA Davies, KT Flaherty, P Burgess, M Tan, E Gasal, M Voi, D Schadendorf, GV Long 

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    Nevus Melanocitico Congénito

    Published in Dermatology

    Journal Scan / Research · September 17, 2019

    Management of Congenital Melanocytic Nevi in the Plastic Surgery Clinic

    Pediatric Dermatology

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    Abstract 

    BACKGROUND

    Children with congenital melanocytic nevi (CMN) were historically managed with surgical removal to lower the risk of malignant transformation. The evolving literature over the last decade has indicated a significantly lower risk than previously estimated. Indications for excision currently revolve around aesthetic and psychosocial concerns. This study describes and evaluates the perspectives and expectations of patients and families referred to a pediatric plastic surgery clinic on CMN management.

    METHOD

    A two-part questionnaire was administered before and after an initial clinic appointment to evaluate patient and family concerns of lesion growth, risk of malignancy, treatment expectations, and stigmatization.

    RESULTS

    Thirty questionnaires were completed for 11 male and 19 female patients, mean age 9.2 years (1-25). Referring doctors (majority dermatologists) were rarely concerned about malignancy (8%), but parents listed it as a top reason for wanting the CMN removed (37%) and the most common expectation for the visit followed by information about surgical options and outcome. Before the clinic, 93% were at least "slightly" worried about CMN growth and 96% about malignancy, whereas 63% and 72%, respectively, after the clinic.

    CONCLUSIONS

    Families want information about surgical excision and are concerned about malignancy, indicating lingering misinformation or misconception about melanoma risk. For the majority, CMN removal remains at least slightly important, presumably for aesthetic reasons and remaining concern about malignancy. Involved health care professionals should assure reliable and coherent patient information about MM risk, indications for surgery and expected outcome to best support families' decision-making.


    Pediatric Dermatology
    Management of Congenital Melanocytic Nevi in the Plastic Surgery Clinic: Families' Expectations and Their Persistent Concern About Malignancy
    Pediatr Dermatol 2019 Aug 29;[EPub Ahead of Print], A Mosa, ES Ho, M Heinelt, K Wong, K Neuhaus 

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    Thursday, September 19, 2019

    Metformin vs. Sulfonylureas in Early Reduced Kidney Function

    Metformin vs. Sulfonylureas in Early Reduced Kidney Function 

    By Kelly Young

    Edited by Susan Sadoughi, MD, and Richard Saitz, MD, MPH, FACP, DFASAM

    Metformin has a better cardiovascular safety profile than sulfonylureas in patients with diabetes and reduced kidney function, according to a JAMA study that is being presented at the European Association for the Study of Diabetes annual meeting.

    Researchers used Veterans Affairs data to compare 25,000 new metformin users with 25,000 new sulfonylurea users who developed reduced kidney function (elevated serum creatinine or reduced estimated glomerular filtration rate) and continued their treatment. During a median 1 year of follow-up, the rate of major adverse cardiovascular events was significantly lower with metformin than with sulfonylureas (23 vs. 29 events per 1000 person-years).

    An editorialist writes: "The study further supports the use of metformin as the first-line treatment to which other diabetes medications are added, even as early chronic kidney disease develops."

    JAMA article (Free)

    JAMA editorial (Subscription required)

    Background: NEJM Journal Watch General Medicine coverage of whether to add or switch to sulfonylureas (Free)


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    Utility of Repeat Latent Tuberculosis Testing With QuantiFERON-TB Gold Test in Psoriasis Patients Treated With TNF-α Inhibitors The British Journal of Dermatology

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    Abstract 
    Risk of latent tuberculosis infection (LTBI) reactivation in psoriasis patients treated with TNF-α inhibitors (TNFIs) is well-known. Thus, some organizations, including the National Psoriasis Foundation, recommend serial LTBI testing in patients receiving long-term TNFI treatment. Additionally, annual LTBI screening has been incorporated into Medicare Merit-Based Incentive Payment Systems (MIPS) quality measures and will impact physician reimbursement.

    The British Journal of Dermatology
    Utility of Repeat Latent Tuberculosis Testing With QuantiFERON-TB Gold Test in Psoriasis Patients Treated With TNF-α Inhibitors at a Single U.S. Institution
    Br J Dermatol 2019 Aug 27;[EPub Ahead of Print], J Ya, U Khanna, S Havele, AP Fernandez 


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    Sunday, September 15, 2019

    Bacteremia en SJS/TEN

    Friday, September 13, 2019

    Apnea y depresión

    Obstructive Sleep Apnea Associated with Later Risk for Depression, Anxiety

    By Amy Orciari Herman

    Edited by André Sofair, MD, MPH

    Adults with obstructive sleep apnea (OSA) may face increased risk for affective disorders, according to a prospective study in JAMA Otolaryngology—Head & Neck Surgery.

    Using national South Korean health insurance data, researchers matched roughly 200 adults with OSA to 800 without apnea. The study excluded those with histories of depression or anxiety. (Information on OSA treatment compliance was unavailable.)

    During 9 years' follow-up, the incidence of affective disorders was 50 per 1000 person-years in the OSA group versus 27 per 1000 in the comparison group. After multivariable adjustment, the OSA group had nearly three times the risk for depressive disorders and nearly twice the risk for anxiety disorders as the comparison group. Risks were higher among females than males.

    The researchers cite evidence suggesting that daytime sleepiness is associated with depression, while other evidence implicates "structural or metabolic changes in the brains of patients with OSA."

    JAMA Otolaryngology—Head & Neck Surgery article (Free abstract)

    Background: NEJM Journal Watch Psychiatry coverage of apnea treatment and improved depression (Your NEJM Journal Watch subscription required)


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    Thursday, September 12, 2019

    Metilmercurio

    Methylmercury In Tainted Anti-Wrinkle Cream Hospitalizes California Woman

    The Washington Post (9/11, Beachum) reports that in July, a "Sacramento woman went to the emergency room in July with numbness in her hands and feet, slurred speech and trouble walking," all effects "from mercury poisoning from a tainted anti-wrinkle cream imported from Mexico, KCRA-TV reported." The woman has remained hospitalized and is now in a "semi-comatose state." According to the Post, "Olivia Kasirye, the public health officer for the Sacramento County Department of Health Services, told CBS Sacramento that the woman's cream contained methylmercury, a very toxic type of mercury." The incident represents "the first time a methylmercury poisoning from face cream has occurred in the United States, the department said in a statement."

            Fox News (9/11, Hein) reports officials are now urging "consumers to stop using similar skin creams imported from Mexico 'due to risk of contamination with methylmercury.'"


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    Trifarotene

    Trifarotene Cream Appears To Be Safe, Well Tolerated In Treatment Of Moderate Facial And Truncal Acne, Phase 3 Trial Indicates

    Healio (9/11, Sutton) reports, "Trifarotene cream was safe and well tolerated in the treatment of moderate facial and truncal acne," investigators concluded in 453-patient, "multicenter, open-label phase 3 clinical trial." The findingswere published online in the Journal of the European Academy of Dermatology and Venereology.


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    Treat to Target a largo plazo?

    Long-Term Advantages May Not Last Following Tight Control In Psoriatic Arthritis, Study Suggests

    Rheumatology News (9/11, Splete) reports, "Patients with psoriatic arthritis who participated in a tight control program for 48 weeks showed no clinical advantage over patients who received usual care when reviewed again five years after having gone back to standard rheumatology care outside of the study," research indicated. The findings, which were "based on data from 110 patients in the TIght COntrol of inflammation in early Psoriatic Arthritis (TICOPA) study," were published online in the journal Rheumatology


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    Melanoma margenes

    https://dacemirror.sci-hub.tw/journal-article/90cc7dddc429fcf0d01cd159903f5940/10.1016@S0140-67361931132-8.pdf

    Aceites y Heridas

    Published in Dermatology

    Journal Scan / Research · September 12, 2019

    The Fatty Acid Composition of Vegetable Oils and Their Potential Use in Wound Care

    Advances in skin & wound care

    Advances in skin & wound care
    The Fatty Acid Composition of Vegetable Oils and Their Potential Use in Wound Care
    Adv Skin Wound Care 2019 Aug 01;32(8)1-8, AQ Alves, VA da Silva, AJS Góes, MS Silva, GG de Oliveira, IVGA Bastos, AG de Castro Neto, AJ Alves 

    Abstract 

    OBJECTIVE

    To evaluate the similarities among fatty acid compositions of vegetable oils sold in the Brazilian market and those present in a reference health product used to treat wounds.

    METHODS

    The relative amounts of fatty acids in 21 types of vegetable oils, purchased in the Brazilian market, were assessed using gas chromatography-mass spectrometry and flame ionization detection.

    MAIN RESULTS

    The studied oils had similar fatty acid compositions to the reference product (caprylic acid, 18.8%; capric acid, 17.4%; oleic acid, 27.5%; and linoleic acid, 28.1%). The presence of caprylic acid (10.45% ± 0.07%), capric acid (5.8% ± 0.75%), lauric acid (45.63% ± 0.93%), and myristic acid (16.33% ± 2.23%) were detected in all the vegetable oils tested. Oleic acid (52.94% ± 12.54%) was present in andiroba, avocado, canola, copaiba, olive, palm, pequi, and pracaxi oils and featured prominently in olive oil (75.8%). Linoleic acid (57.09% ± 8.47%) was present in corn, cottonseed, grapeseed, passion fruit, and sunflower oils and in mixed oils (olive with soybean and sunflower with corn and canola).

    CONCLUSIONS

    Most of the vegetable oils tested are products of plants from tropical climates, where they are abundant and easy to cultivate. It is possible that a balanced composition of fatty acids obtained from natural sources could be an effective alternative treatment for wounds.


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    Benjamin Hidalgo-Matlock
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