Evaluation of cardiovascular risk in patients with psoriatic disease in a multiracial population: a cross-sectional study.

BACKGROUND: Psoriatic disease (PD) is a chronic inflammatory disorder often associated with cardiovascular risk (CVR) factors such as obesity, hypertension, diabetes, dyslipidaemia and smoking. It is estimated that 2%-4% of the population worldwide has PD. Cutaneous lesions of psoriasis (PsO) may be associated with psoriatic arthritis (PsA) in up to 40% of patients. Studies have been carried out around the world with the aim of evaluating CVR in such patients. AIM: To determine CVR in a multiracial population with PsA or PsO from southeastern Brazil, which has a predominantly tropical climate, compared with controls. METHODS: A cross-sectional study was carried out in outpatients with PsO or PsA followed up at a quaternary referral hospital in Rio de Janeiro. The Framingham Risk Score (FRS) was used to predict cardiovascular events (CVEs) over 10 years in patients with PsO and PsA compared with controls. RESULTS: FRS was significantly higher at 10 years in patients with PsO (mean ± SD 16.3 ± 14) and PsA (18.0 ± 15) compared with controls (10.6 ± 9.5) (P = 0.01) and also increased with age. The chance of having a high FRS in the PsO and PsA groups increased by 0.30 and 0.23 times per year, respectively, compared with controls (PsO vs. controls 95% CI 0.090-1.00; PsA vs. controls 95% CI 0.08-0.75). CONCLUSION: In this multiethnic Brazilian population, both PsO and PsA were associated with higher CVR compared with controls. The frequency of high FRS was highest in the sixth decade of life for all three groups of participants. Annual assessment of patients with PD is necessary in order to prevent CVEs.

Carboxymethyl Cellulose, Trichloroacetic Acid, and Unna Boot for Healing Venous Ulcers: A Comparative Study of Their Efficacy and Socioeconomic Impact.

Chronic ulcers are defined as a breakdown of the long-term cutaneous barrier or frequent recurrence of breakdowns. Dressings are a form of treatment and, in view of the variety and high cost of the products on the market, three agents were selected for this investigation, regarding their efficacy and cost/benefit ratio. The objective of the investigation was to evaluate and compare the efficacy, costs, and benefits of carboxymethylcellulose in paste at 20% (CMC 20%), trichloroacetic acid at 90% (TCA 90%), and Unna boot for treatment of chronic venous ulcers. Three groups of 30 patients each were chosen randomly for ambulatory treatment with TCA 90% (G1), CMC 20% (G2), and Unna boot (G3). The evolution of the cicatricial process of each group separately and between groups was analyzed with measurement of the lesion areas in square centimeters (cm2) and observation of the amount of exudate from observation of the photographic record, until their healing, in the maximum period of 20 weeks. A significant reduction of lesion areas in all groups was observed (P=.0001), with a median reduction of 7.6 cm2 (38.1%) for G1, 3.9 cm2 (38.8%) for G2, and 16.2 cm2 (77.8%) for G3. There was a significant difference in the absolute delta of the lesion areas (P=.0001) of the groups. The three types of treatments promoted effective improvement, with acquisition and utilization of all three products in the public health services being recommended.

Evaluation of treatment with carboxymethylcellulose on chronic venous ulcers.

BACKGROUND: Among the chronic leg ulcers, venous ulcers are the most common and constitute a major burden to public health. Despite all technology available, some patients do not respond to established treatments. In our study, carboxymethylcellulose was tested in the treatment of refractory chronic venous ulcers. OBJECTIVE: To evaluate the efficacy of carboxymethylcellulose 20% on the healing of chronic venous ulcers refractory to conventional treatments. METHODS: This is an analytical, pre-experimental study. Thirty patients were included with refractory venous ulcers, and applied dressings with carboxymethylcellulose 20% for 20 weeks. The analysis was based on measurement of the area of ulcers, performed at the first visit and after the end of the treatment. RESULTS: There was a reduction of 3.9 cm2 of lesion area (p=0.0001), corresponding to 38.8% (p=0.0001). There was no interruption of treatment and no increase in lesion area in any patient. CONCLUSIONS: Carboxymethylcellulose 20% represents a low cost and effective therapeutic alternative for the treatment of refractory chronic venous ulcers. However, controlled studies are necessary to prove its efficacy.

Evaluation of treatment with carboxymethylcellulose on chronic venous ulcers

Abstract BACKGROUND: Among the chronic leg ulcers, venous ulcers are the most common and constitute a major burden to public health. Despite all technology available, some patients do not respond to established treatments. In our study, carboxymethylcellulose was tested in the treatment of refractory chronic venous ulcers. OBJECTIVE: To evaluate the efficacy of carboxymethylcellulose 20% on the healing of chronic venous ulcers refractory to conventional treatments. METHODS: This is an analytical, pre-experimental study. Thirty patients were included with refractory venous ulcers, and applied dressings with carboxymethylcellulose 20% for 20 weeks. The analysis was based on measurement of the area of ulcers, performed at the first visit and after the end of the treatment. RESULTS: There was a reduction of 3.9 cm2 of lesion area (p=0.0001), corresponding to 38.8% (p=0.0001). There was no interruption of treatment and no increase in lesion area in any patient. CONCLUSIONS: Carboxymethylcellulose 20% represents a low cost and effective therapeutic alternative for the treatment of refractory chronic venous ulcers. However, controlled studies are necessary to prove its efficacy.