Assessment of auditory function and lipid levels in patients receiving oral isotretinoin (13-cis retinoid) therapy for acne vulgaris

Abstract

Introduction: Isotretinoin (13-cis retinoid) is a synthetic retinoid. It was approved by the FDA in 1982 for use of oral isotretinoin in severe acne. It is also used in moderate-severe acne that does not respond to conventional treatments. Isotretinoin is the only available drug that affects all stages of acne pathogenesis. Aim: To prospectively investigate whether there is an effect of isotretinoin therapy on auditory function and, if so, to demonstrate its association with simultaneous blood lipid levels. Material and methods: Thirty patients (60 ears) with acne vulgaris, who received 0.5 mg/kg of isotretinoin therapy, were included in the study. Distortion product otoacoustic emissions (DPOAEs) and pure tone audiometry tests were performed to evaluate auditory function at the beginning of the procedure and the 6th month of treatment. In addition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, triglyceride, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol levels were recorded. Results: There was no statistically significant difference between pre-treatment and post-treatment mean pure tone audiometry threshold and DPOAE values; however, the increase in total blood cholesterol, triglyceride and LDL levels and the decrease in HDL levels were statistically significant. Conclusions: According to our study findings, isotretinoin did not cause worsening of the bilateral hearing threshold, but increased blood lipid levels. There is no need for follow-up auditory functions in routine practice during therapy, but blood lipid levels should be monitored. Sapanca Lake is an important drinking water source located by D-100 highway in the north and E-80 (TEM Anatolian Highway) and a railway line in the south. Heavy metal concentrations in roadside soils result from vehicle exhausts and the corroding metal parts of vehicles. Due to the difficulty of removing heavy metals from the soil, a significant pollution problem arises and this pollution also affects the water resources by means of rain. Although there are several industries, the highway located near the lake is the most important pollutant source for Sapanca Basin. Therefore, this study evaluated heavy metal concentrations, the chemical fractions of the metals and ecological risks (by using C-f, RAC and PERI) in the soil samples collected seasonally between 2015 and 2017 in Sapanca Lake Basin. Al and Fe were determined at very high amounts in all stations and the relationship between mean concentrations of other metals was determined to be Zn>Ba>As>Ni>Cr>Pb>Cu>Co>Cd. However, Zn, Ba, As, Ni, Cr, Pb, Cu, Co and Cd mean concentrations were determined as 87.63 mg/kg, Ba 86.87 mg/kg, 80.40 mg/kg, 58.62 mg/kg, 50.42 mg/kg, 41.90 mg/kg, 38.16 mg/kg, 13.98 mg/kg, 2.89 mg/kg respectively. Al, Fe, Co, Cr, Cu, Ni and Zn are mainly found in residual fractions in soil. According to the environmental risk assessment on the basis of soil stations, the 7th station has the highest GC(f) value, which means that the soil sample presents the highest environmental risk according to the contamination factors. On the other hand, Cd has serious potential ecological risk and As has considerable potential ecological risk in all stations. In this work, theoretical calculations are modeled by using density functional theory including van der Waals effects. We have investigated the binding mechanism, as well as magnetic and electronic properties of basic amino acids such as histidine and leucine with titanium/carbon functionalized graphene. We also focused on the effects of charging on the structural, magnetic, and electronic properties. We have shown that binding energy and magnetic and electronic properties may be altered by adding or removing an electron to/from the system. Charging can change the band structure dramatically, so in some spin up/down cases, the system becomes semiconductor. Functionalization performing with charging allows us to design some spintronic devices and/or biosensors for detecting histidine and leucine for low concentration levels.