Meme kanserli olgularda 3 alanlı koplanar teknikle tüm meme ışınlamasının kalp ve LAD dozlarına etkisi

Objectives We evaluate the effect of two conformal technique at Turkish women contour which developed order to reduce the lung dose in whole breast radiotherapy at European breast cancer patients. Methods CTV, PTV, lung, heart, contralateral breast and LAD were contoured on 20 patients referred for breast radiotherapy. Treatment planning were made as conventional technique (2F-C), two field non-coplanar conformal technical (2F-NC), 3 field coplanar conformal technique (3F-C) at Varian Eclipse TPS. Critical doses were evaluated at DVH. Conformity and homogeneity index was calculated. Comparison of three groups made by Kruskal-Wallis test, two separate groups by Mann-Whitney U test. Results Statistically significant differences in favor of 3F-C were detected on hearth, LAD, contralateral breast doses. Homogeneity and conformity index was higher for all patients in 3F-C technique. Conclusion 3F-C technique is adequate for dosimetric aspects and can be considered in Turkish women especially have coronary artery disease. © 2014 Turkish Society for Radiation Oncology

Subclinical hypothyroidism in childhood — current knowledge and open issues

Subclinical hypothyroidism is defined as serum levels of TSH above the upper limit of the reference range, in the presence of normal concentrations of total T4 or free T4. This biochemical profile might be an indication of mild hypothyroidism, with a potential increased risk of metabolic abnormalities and cardiovascular disease recorded among adults. Whether subclinical hypothyroidism results in adverse health outcomes among children is a matter of debate and so management of this condition remains challenging. Mild forms of untreated subclinical hypothyroidism do not seem to be associated with impairments in growth, bone health or neurocognitive outcome. However, ongoing scientific investigations have highlighted the presence of subtle proatherogenic abnormalities among children with modest elevations in their TSH levels. Although current findings are insufficient to recommend levothyroxine treatment for all children with mild asymptomatic forms of subclinical hypothyroidism, they highlight the potential need for assessment of cardiovascular risk among children with this condition. Increased understanding of the early metabolic risk factors associated with subclinical hypothyroidism in childhood will help to improve the management of affected individuals

Anthropometric findings from birth to adulthood and their relation with karyotpye distribution in Turkish girls with Turner syndrome

To evaluate the anthropometric features of girls with Turner syndrome (TS) at birth and presentation and the effect of karyotype on these parameters. Data were collected from 842 patients with TS from 35 different centers, who were followed-up between 1984 and 2014 and whose diagnosis age ranged from birth to 18 years. Of the 842 patients, 122 girls who received growth hormone, estrogen or oxandrolone were excluded, and 720 girls were included in the study. In this cohort, the frequency of small for gestational age (SGA) birth was 33%. The frequency of SGA birth was 4.2% (2/48) in preterm and 36% (174/483) in term neonates (P<0.001). The mean birth length was 1.3cm shorter and mean birth weight was 0.36kg lower than that of the normal population. The mean age at diagnosis was 10.1±4.4 years. Mean height, weight and body mass index standard deviation scores at presentation were -3.1±1.7, -1.4±1.5, and 0.4±1.7, respectively. Patients with isochromosome Xq were significantly heavier than those with other karyotype groups (P=0.007). Age at presentation was negatively correlated and mid-parental height was positively correlated with height at presentation. Mid-parental height and age at presentation were the only parameters that were associated with height of children with TS. The frequency of SGA birth was found higher in preterm than term neonates but the mechanism could not be clarified. We found no effect of karyotype on height of girls with TS, whereas weight was greater in 46,X,i(Xq) and 45,X/46,X,i(Xq) karyotype groups. © 2016 Wiley Periodicals, Inc