ABSTRACT
Objectives Premature coronary artery disease is the most common preventable cause of death in developed countries, and familial hypercholesterolemia (FH) is the most common monogenetic disorder of lipid metabolism, predisposing for premature coronary artery. FH is the most common preventable cause of death in developed countries. In 2016, the national lipid screening program in school-age children has been started in Turkey. In this study, we aimed to evaluate the efficacy of lipid screening program, lipid-lowering treatments, and the challenges of treatments in children diagnosed with FH. Methods Patients diagnosed with FH in the pediatric metabolism outpatient clinic were retrospectively evaluated. Changes in lipid profile with dietary interventions and statin treatments were assessed. The results of cascade screening were analyzed. Results Fifty-one patients diagnosed with FH were enrolled in the study. Twenty-four (47.1%) were female. The mean age of the patients was 9.8 ± 3.2 years. Heterozygous LDLR gene mutation was detected in all patients. Three novel pathogenic variations were revealed with the genetic investigation. Forty-one (80.4%) patients had high adherence to CHILD-2 dietary recommendations. The mean low-density lipoprotein cholesterol (LDL-C) level decreased by 14.5 ± 7.6% after dietary intervention. Parents refused to start statin treatment in 8 (15.7%) patients. Statin treatment was initiated to 22 (43.1%) patients. Mean LDL-C level decreased from 204.1 ± 19.1 mg/dL to 137.0 ± 13.1 mg/dL. In cascade screening, 7 (13.7%) parents without a diagnosis of FH were diagnosed with FH. After the screening program, statin treatment was initiated for 18 (35.3%) parents and 7 (16.3%) siblings. Conclusions We can conclude that screening for FH in children is crucial for diagnosing FH not only in children but also in their relatives. Although statins are safe and effective in achieving the target LDL-C level, we determined significant resistance for initiating statin treatment in patients.
Subject(s)
Diet , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hyperlipoproteinemia Type II/diagnosis , Hyperlipoproteinemia Type II/drug therapy , Mass Screening/methods , Mutation , Receptors, LDL/genetics , Child , Female , Follow-Up Studies , Humans , Hyperlipoproteinemia Type II/epidemiology , Hyperlipoproteinemia Type II/genetics , Male , Prognosis , Retrospective Studies , Risk Factors , Turkey/epidemiologyABSTRACT
OBJECTIVES: The objective of this study was to evaluate the effect of sevoflurane and isoflurane in nasal septal surgery in terms of intraoperative blood loss, operation time, recovery time, and especially postoperative pain. METHODS: A total of 90 elective nasal septal surgery patients between the ages of 19 and 58 years (mean age, 32.95 years) who were classified as American Society of Anesthesiologists physical status I and II between January 2011 and June 2012 were included the study. Patients were assigned by randomization to receive 1 of 2 anesthetic agents (n = 45 patients each group): balanced general anesthesia with sevoflurane or isoflurane group. In all patients, the amount of intraoperative blood loss, the duration of operation, recovery time, and postoperative pain scores were recorded. RESULTS: The amount of perioperative bleeding in sevoflurane cases was less than that in the isoflurane group, and the difference was statistically significant (P G 0.05). Similarly, mean operative time was shorter in the sevoflurane group, and again the difference between 2 groups was statistically significant (P G 0.05). No statistically significant differences were observed between the 2 groups with respect to the anesthesia duration, extubation time, recovery time, and postoperative pain scores (P 9 0.05). CONCLUSIONS: Sevoflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding, postoperative pain, and operation time than isoflurane during nasal septal surgery.
Subject(s)
Anesthetics, Inhalation/administration & dosage , Isoflurane/administration & dosage , Methyl Ethers/administration & dosage , Nasal Septum/surgery , Adult , Anesthesia Recovery Period , Anesthesia, General , Blood Loss, Surgical , Female , Follow-Up Studies , Humans , Male , Middle Aged , Nasal Obstruction/surgery , Operative Time , Pain Measurement/methods , Pain, Postoperative/etiology , Sevoflurane , Young AdultABSTRACT
OBJECTIVES: The objective of this study was to evaluate the effect of sevoflurane and isoflurane in nasal septal surgery in terms of intraoperative blood loss, operation time, recovery time, and especially postoperative pain. METHODS: A total of 90 elective nasal septal surgery patients between the ages of 19 and 58 years (mean age, 32.95 years) who were classified as American Society of Anesthesiologists physical status I and II between January 2011 and June 2012 were included the study. Patients were assigned by randomization to receive 1 of 2 anesthetic agents (n = 45 patients each group): balanced general anesthesia with sevoflurane or isoflurane group. In all patients, the amount of intraoperative blood loss, the duration of operation, recovery time, and postoperative pain scores were recorded. RESULTS: The amount of perioperative bleeding in sevoflurane cases was less than that in the isoflurane group, and the difference was statistically significant (P < 0.05). Similarly, mean operative time was shorter in the sevoflurane group, and again the difference between 2 groups was statistically significant (P < 0.05). No statistically significant differences were observed between the 2 groups with respect to the anesthesia duration, extubation time, recovery time, and postoperative pain scores (P > 0.05). CONCLUSIONS: Sevoflurane, which is one of the volatile anesthetics, leads to a lower amount of intraoperative bleeding, postoperative pain, and operation time than isoflurane during nasal septal surgery.
