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Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

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Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#31
post #24

Earlier quoted context omitted.

Medsafe's strategy only works so long as there is at least one stringent regulator though.

I would think for a country like Australia a more moderate approach would be to approve things that were approved by other countries and have been in use for some amount of time - say, 5 years or so - apart from the things they directly approve.

The actual drug my father and I were discussing was clonidine.

In the UK and New Zealand, they sell 25 microgram clonidine tablets; in Australia, the smallest dose on sale is 100 micrograms.

Clonidine is a very old drug – it was released back in the 1960s. The risks involved are very well understood (arguably the biggest risk is fatal overdoses, but patient/parent education is the accepted mitigation strategy.)

The issue is, in Australia, it is only approved for treating high blood pressure in adults. Paediatricians and child psychiatrists commonly prescribe it for ADHD, and for anxiety, aggression and insomnia (particularly but not exclusively in the context of ASD); in adults, it is prescribed to treat menopausal hot flushes and migraines – but all those indications are off-label.

And this is the problem – given the doses involved, 25 microgram tablets only really make sense for those off-label indications, there isn't much demand for them for treating adult hypertension. So to get the TGA to approve 25 microgram clonidine tablets, you need to prove to them that clonidine is safe and effective for one of those currently off-label indications. And that will cost a lot of money, and given it is a generic medication long out of patent protection, it isn't worthwhile. Whereas Medsafe quite possibly just decided "the UK approved it for X so we will too".

As a parent, both of whose children are prescribed clonidine, this annoys me – cutting tablets in half is no fun, and cutting them into quarters is even worse. Or I can get them compounded into liquid by a compounding pharmacist, which makes it easier to measure out smaller doses (I always get 25 microgram/ml), but that adds expense and time (the nearest compounding pharmacy is 15 minutes drive one way). I just wish I could get 25 microgram tablets, but they can't legally be sold in Australia–possibly I could ask our child psychiatrist to apply for special permission to import them from New Zealand, but the amount of bureaucracy involved probably isn't worth it, there's no guarantee the request would be approved, and it would be expensive (it wouldn't be covered by our national prescription drug insurance).

Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#33
post #17

I thought this a pretty mature technique? I have seen more than once our local vet using this technique to treat cats with large wounds -- with great results by the way. Interestingly, they too used tilapia fish skin, and not any of the more common local fish species. I wonder if there is something special about tilapia fish skin, or it was simply the species on which the technique was developed, and nobody bothered…

What's special is that tilapia is probably cheaper than even the local fish since it's farmed in massive quantities and shipped all over the world as food. If other fish skins were tried it must have been similar results.

Tilapia imports are heavily restricted to Australia, The live fish will not be allowed, they are considered "restricted noxious fish".

The rules are:

Illegal to Keep: You cannot keep tilapia (dead or alive), sell them, give them away, or use them as bait.

Immediate Euthanasia: Humanely kill the fish as soon as you catch it.

Disposal:

Bury: Bury them deep and well away from the water's edge to prevent scavengers from dragging them back in or floodwaters from releasing eggs.

Bin: Place them in a rubbish bin.

No Filleting: You cannot take fillets and dispose of the rest; the entire fish must be destroyed.

Various state departments have hotlines for reporting tilapia.

There are different hotlines per state:

Queensland Department of Agriculture and Fisheries (DAF) (13 25 23)

New South Wales Department of Primary Industries (DPI) (1800 675 888)

Victoria (VFA) Reporting hotline (13FISH or 13 34 74)

Western Australia Dept. of Primary Industries & Regional Development (1800 815 507)

I've had rewards for reporting them (fishing reel, free bait, etc).

Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#35

They used this exact treatment in an episode of The Good Doctor, S01E06. Original air date: October 30, 2017 https://the-good-doctor.fandom.com/wiki/Not_Fake

Yes, but the treatment has been devised way prior to 2017.

Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#36
There is an Icelandic company called Kerecis that produces these kinds of fish skin based grafts. There are some videos of some of their patient's before and after over at their webpage[0] but be warned, they might be a bit graphic for some.

[0]: https://kerecis.com

Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#37

It's old news. There is even “And Dream of Sheep” — Grey’s Anatomy, Season 15 Episode 17. That’s the episode where they mention using tilapia fish skin to treat burns. Original U.S. air date: March 14, 2019.

2019? I'm surprised they kept it running for that long.

Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#38

Earlier quoted context omitted.

What's special is that tilapia is probably cheaper than even the local fish since it's farmed in massive quantities and shipped all over the world as food. If other fish skins were tried it must have been similar results.

Tilapia imports are heavily restricted to Australia, The live fish will not be allowed, they are considered "restricted noxious fish". The rules are: Illegal to Keep: You cannot keep tilapia (dead or alive), sell them, give them away, or use them as bait. Immediate Euthanasia: Humanely kill the fish as soon as you catch it. Disposal: Bury: Bury them deep and well away from the water's edge to prevent scavengers from…

For those that don't know why, and I didn't, the reason for this is that Tilapia are "mouth brooders", that is they keep the fertilised eggs in their mouth. So throwing away a dead female can cause these eggs to hatch, and reinfect the waters with new Tilapia.

Re: Doctors in Brazil using tilapia fish skin to treat burn victims (2017)

#40
post #9

It's old news. There is even “And Dream of Sheep” — Grey’s Anatomy, Season 15 Episode 17. That’s the episode where they mention using tilapia fish skin to treat burns. Original U.S. air date: March 14, 2019.

Doesn't make it any less interesting. And in spite of it not being new, it doesn't look like it's out of the experimental stage: the article mentions it's difficult to get the tilapia skin processed and sterilized.

The article is 9 years old so that may no longer be the case
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