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INTRODUCTION: The fruit oil from Acrocomia aculeata (Macauba or Bocaiuva) is highly rich in antioxidants and other bioactive compounds, emerging as a natural source of high potential for the modulation of chronic non-communicable diseases (NCDs), like diabetes. Its effects on chronic NCDs are poorly studied yet. Our review aimed to evaluate the therapeutic results of pharmaceutical preparations containing Acrocomia aculeata pulp oil that are used for chronic NCDs. METHOD: A search was performed using PICO acronyms in English, Portuguese, and Spanish languages in the MEDLINE®, PubMed, EMBASE, Scopus, LILACs, and CENTRAL Cochrane Library databases. The degree of agreement for selection and eligibility was significant (Kappa= 0.992; 95% CI: 0.988-0.996). The difference between the intervention and control groups for blood glucose reduction was 63.5 ± 69.5 mg/dL (p<0.0001). RESULT: Overall, an improvement percentage of 55.1 ± 0.1 was observed for the variables associated with chronic NCDs, which represented 89.96% of the relative risk reduction (efficacy). CONCLUSION: The Acrocomia aculeate pulp oil exhibited promising results in experimental studies for glycemic control and reduction of a specific tumor, indicating a good potential to be explored for chronic NCDs treatment.
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Atopic dermatitis (AD) is a chronic inflammatory skin disease that is difficult to treat. Traditional cold cream, a water-in-oil emulsion made from beeswax, is used to alleviate AD symptoms in clinical practice, although its effectiveness has not been scientifically proven. The addition of propolis has the potential to impart anti-inflammatory properties to cold cream. However, in high concentrations, propolis can trigger allergic reactions. Thus, the objective of this work was to develop a cold cream formulation based on purified beeswax containing the same amount of green propolis present in raw beeswax. The impact of adding this low propolis concentration to cold cream on AD control was evaluated in patients compared to cold cream without added propolis (CBlank). Raw beeswax was chemically characterized to define the propolis concentration added to the propolis-loaded cold cream (CPropolis). The creams were characterized as to their physicochemical, mechanical, and rheological characteristics. The effect of CPropolis and CBlank on the quality of life, disease severity, and skin hydration of patients with AD was evaluated in a triple-blind randomized preclinical study. Concentrations of 34 to 120 ng/mL of green propolis extract reduced TNF-α levels in LPS-stimulated macrophage culture. The addition of propolis to cold cream did not change the cream's rheological, mechanical, or bioadhesive properties. The preclinical study suggested that both creams improved the patient's quality of life. Furthermore, the use of CPropolis decreased the disease severity compared to CBlank.
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INTRODUCTION: Type 2 diabetes mellitus (T2DM) has burdened health systems in the world to the value of 500 billion dollars/year. Dipeptidyl peptidase 4 inhibitors (DPP-4 Inhibitors) have been strongly associated with spending on the treatment of T2DM by the courts in Brazil. The aim of this study was to estimate the most cost-effective DPP-4 Inhibitor for T2DM treatment. A pharmacoeconomic study of cost-effectiveness was performed in a medium-sized municipality in Minas Gerais state, Brazil. METHODS: The data are from legalization in municipal health in 2013. The effectiveness of DPP-4 Inhibitors was measured by the reduction in glycated hemoglobin (A1c). The direct medical costs of drug and adverse drug reactions were identified. With these data, a cost-effectiveness ratio (CER) and construction of the decision tree for sensitivity analysis were performed. RESULTS: The representative of the most effective in reducing A1c gliptins was sitagliptin in combination with metformin, it was able to reduce A1c by 1.16% (1.09 to 1.22, CI 95%). The drug with the lowest cost was linagliptin, with a cost per patient/year of US$ 481.42. Sensitivity analysis performed by the decision tree shows that sitagliptin in association with metformin had the CER of US$ 1,506.75 per patient/year, to reduce A1c by 1%. CONCLUSION: The most cost-effective DPP-4 Inhibitor was sitagliptin with metformin.