Treatment of acne with intermittent and conventional isotretinoin: a randomized, controlled multicenter study

Oral isotretinoin is the most effective choice in the treatment of severe acne. Application of isotretionin to acne has been expanded to treat those patients with less severe but scarring acne who are responding unsatisfactorily to conventional therapies. However, its use is associated with many side effects, some of which can result in very disastrous consequences. Data related with intermittent isotretinoin therapy is still limited. Our aim was to asses the efficacy and tolerability of two different intermittent isotretinoin courses and compare them with conventional isotretinoin treatment. In this multicenter and controlled study, 66 patients with moderate to severe cases were randomized to receive either isotretionin for the first 10 days of each month for 6 months (group 1), or each day in the first month, afterwards the first 10 days of each month for 5 months (group 2) or daily for 6 months (group 3). The drug dosage was 0.5 mg/kg/day in all groups. Patients were followed-up for 12 months. Efficacy values were evaluable for 22 patients in group 1, 19 patients in group 2, and 19 patients in group 3. Acne scores in each group were significantly lower at the end of treatment and follow-up periods (P < 0.001). When patients were evaluated separately as moderate (n = 31) and severe (n = 29), no statistically significant differences were obtained among the treatment protocols in patients with moderate acne. However, there was a significant difference between groups 1 and 3 to the response of the treatments in severe acne patients at the end of follow-up period (P = 0.013). The frequency and severity of isotretionin-related side effects were found to be lower in groups 1 and 2 compared with group 3. Intermittent isotretinoin may represent an effective alternative treatment, especially in moderate acne with a low incidence and severity of side effects. The intermittent isotretinoin can be recommended in those patients not tolerating the classical dosage

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol for a randomized controlled trial

Background: Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multicenter, two-arm, international randomized controlled trial. In total, 2013 obese patients with body mass index ≥35 kg/m2 scheduled for at least 2 h of surgery under general anesthesia and at intermediate to high risk for PPCs will be included. Patients are ventilated intraoperatively with a low tidal volume of 7 ml/kg (predicted body weight) and randomly assigned to PEEP of 12 cmH2O with lung recruitment maneuvers (high PEEP) or PEEP of 4 cmH2O without recruitment maneuvers (low PEEP). The occurrence of PPCs will be recorded as collapsed composite of single adverse pulmonary events and represents the primary endpoint. Discussion To our knowledge, the PROBESE trial is the first multicenter, international randomized controlled trial to compare the effects of two different levels of intraoperative PEEP during protective low tidal volume ventilation on PPCs in obese patients. The results of the PROBESE trial will support anesthesiologists in their decision to choose a certain PEEP level during general anesthesia for surgery in obese patients in an attempt to prevent PPCs. Trial registration ClinicalTrials.gov identifier: NCT02148692. Registered on 23 May 2014; last updated 7 June 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1929-0) contains supplementary material, which is available to authorized users

Impedimetric Detection Based on Label-Free Immunoassay Developed for Targeting Spike S1 Protein of SARS-CoV-2

After the COVID-19 pandemic started all over the world, great importance was placed on the development of sensitive and selective bioanalytical assays for the rapid detection of the highly pathogenic SARS-CoV-2 virus causing COVID-19 disease. In this present work, an impedimetric immunosensor was developed and applied for rapid, reliable, sensitive and selective detection of the SARS-CoV-2 S1 protein. To detect the SARS-CoV-2 virus, targeting of the spike S1 protein was achieved herein by using S1 protein-specific capture antibody (Cab-S1) immobilized screen-printed electrode (SPE) in combination with the electrochemical impedance spectroscopy (EIS) technique. With the impedimetric immunosensor, the detection limit for S1 protein in buffer medium was found to be 0.23 ng/mL (equal to 23.92 amol in 8 mu L sample) in the linear concentration range of S1 protein from 0.5 to 10 ng/mL. In the artificial saliva medium, it was found to be 0.09 ng/mL (equals to 9.36 amol in 8 mu L sample) in the linear concentration range of S1 protein between 0.1 and 1 ng/mL. The selectivity of the impedimetric immunosensor toward S1 protein was tested against influenza hemagglutinin antigen (HA) in the buffer medium as well as in artificial saliva.Scientific and Technological Research Council of Turkey [120S419]This research was funded by Scientific and Technological Research Council of Turkey grant number TUB.ITAK Project No. 120S419

Amperometric immunosensor developed for sensitive detection of SARS-CoV-2 spike S1 protein in combined with portable device

In this present study, an amperometric immunosensor was developed based on disposable screen-printed carbon electrode (SPCE) for specific and sensitive detection of SARS-CoV-2 S1 protein. Anti-SARS-CoV-2 S1 monoclonal antibody was firstly immobilized onto the electrode surface. Then, the sandwich complex was formed by addition of S1 protein, secondary antibody and HRP-IgG, respectively. Chronoamperometry measurements were done in the presence of TMB mediator and the detection of SARS-CoV-2 S1 protein was performed by using 10 mu L sample. The limit of detection (LOD) was found to be 0.19 ng/mL (equals to 24.7 amol in 10 mu L sample) in the linear range of 0.5-10 ng/mL obtained in buffer medium. The applicability of this assay was investigated in the linear range of 0.5-3 ng/mL S1 protein in artificial saliva medium with the LOD as 0.13 ng/mL (equals to 16.9 amol in 10 mu L sample). The selectivity study was examined in the presence of Hemagglutinin antigen (HA) in both mediums; buffer and artificial saliva while resulting with the successful discrimination between S1 protein and HA. The one of ultimate goals of our study is to present the possible implementation of this assay to point of care (POC) analysis. Under this aim, this assay was performed in combination with a portable device that is the commercial electrochemical analyzer. Amperometric detection of S1 protein in the range of 0.5-5 ng/mL was also successfully performed in artificial saliva medium with a resulting LOD as 0.15 ng/mL (equals to 19.5 amol in 10 mu L sample). In addition, a selectivity study was similarly carried out by portable device.Turkish Scientific and Technological Research Council (TUEBITAK, Turkey)A.E acknowledges the financial support from Turkish Scientific and Technological Research Council (TUEBITAK, Turkey) (Project No. 120S419) as the Project Investigator, and she also would like to express her gratitude to the Turkish Academy of Sciences (TUEBA, Turkey) as an Principal member for its partial support. H.S, E.Y and M.M acknowledge project scholarship by TUEBITAK (Project No. 120S419) . The authors acknowledge BioRender.com for aid in creating partially some graphical elements in graphical abstract, Figs. 1 and 2

Comparison of epidural analgesia combined with general anesthesia and general anesthesia for postoperative cognitive dysfunction in elderly patients.

BACKGROUND: Cognitive dysfunction in the early postoperative course is common for the elderly population. Anesthetic management may affect postoperative cognitive decline. Effective analgesia, early recovery and modulation of the stress response are advantages of neuraxial blocks. This study aims to compare the effects of general anesthesia and the combination of general anesthesia with epidural analgesia for postoperative cognitive dysfunction (POCD). We hypothesized that neuraxial block combined with general anesthesia (GA) would have a favorable influence on POCD prevention

EFFECT OF URIDINE DIPHOSPHATE-GLUCURONOSYLTRANSFERASE POLYMORPHISMS ON THE PLASMA CONCENTRATIONS OF MYCOPHENOLIC ACID IN TURKISH RENAL TRANSPLANT PATIENTS

Objective: The pharmacokinetics of mycophenolic acid (MPA) differ among individuals. MPA is primarily metabolized by uridine diphosphate-glucuronosyltransferase (UGT), and UGT2B7 is an important UGT for the glucuronidation of MPA. This study aimed to examine the pharmacokinetics of MPA in Turkish renal transplant patients with UGT2B7 His268Tyr (802C>T) polymorphisms