Techniques for Thyroidectomy and Functional Neck Dissection

Thyroidectomy is a commonly performed surgery for thyroid cancer, Graves’ disease, and thyroid nodules. With the increasing incidence of thyroid cancer, understanding the anatomy and surgical techniques is crucial to ensure successful outcomes and minimize complications. This review discusses the anatomical considerations of the thyroid and neck, including lymphatic drainage and the structures at risk during thyroidectomy. Emphasis is placed on the significance of cautious dissection to preserve critical structures, such as the parathyroid glands and recurrent laryngeal nerve. Neck dissection is also explored, particularly in cases of lymph node metastasis, in which its proper execution is essential for better survival rates. Additionally, this review evaluates various thyroidectomy techniques, including minimally invasive approaches, highlighting their potential benefits and limitations. Continuous surgical knowledge and expertise updates are necessary to ensure the best results for patients undergoing thyroidectomy

The effect of terıparatıde therapy on regulators of bone turnover and qualeffo-41

Aim: The aim of this cross-sectional study was to compare the effects of teriparatide therapy on anabolic hormones and bone turnover markers and quality of life in patients with osteoporotic fractures. Material and method: Patients with severe osteoporosis defined as lumbar total T-score or femur neck T-score ;amp;#8804; -4.0 and at least 2 lumbar vertebral compression fractures were enrolled. 15 patients were on teriparatide therapy and 15 patiens had no therapy. ALP, osteocalcin, GH, IGF-1, IGFBP and SHBG levels were determined. QUALEFFO-41 was used for QOL evalu- ation. Findings: In the teriparatide group ALP and osteocalcin levels were significantly higher (p;lt;0.05). GH, IGF-1, IGFBP and SHBG levels did not differ significantly (P;gt;0.05). In teriparatide patients, physical function (a,b,c,d,e), general health evalua- tion (f) and total QUALEFFO-41 scores were significantly lower, while mental function (g) scores were significantly higher (p;lt;0.05). Physical function scores b and c were negatively correlated with IGF-1 (p;lt;0.05). Treatment duration in teriparatide group was negatively correlated with physical function scores a, b, c, d and general health score (f) (p;lt;0.05). Conclusion: In this study teriparatide therapy was shown to raise the levels of bone turnover markers significantly and affect quality of life positively in osteoporotic patients with vertebral fractures and these improvements were correlated with treat- ment duration.Amaç: Osteoporotik vertebral kırık nedeniyle teriparatid tedavisi alanlarda kemik döngüsü düzenleyicileri ile yaşam kalitesi ölçütlerinin incelenmesi. Gereç ve Yöntem: Çalışmaya kemik mineral yoğunluğu ölçüm değerlerine göre ileri osteoporotik (toplam lomber omurga veya femur bölgesi T skoru ? -4.0 ) ve en az iki vertebrada kompresyon fraktürü olan olgular (Grup B, s=15, teriparatid alan / Grup A, s=15, tedavi almayan) alındı. Serum ALP, osteokalsin, BH, IBF-1, IBFBP-3 ve SHBG değerlendirildi. Yaşam kali- tesi özel bir anket olan QUALEFFO-41 ile değerlendirildi. Bulgular: Tedavi grubunda alkalen fosfataz ve osteokalsin değerleri kontrol grubuna göre anlamlı yüksekti (p0,05). BH, IBF-1, IBFBP-3 ve SHBG açısından gruplar arasında anlamlı fark yoktu (p>0,05). Tedavi alan grupta fiziksel işlev (a,b,c,d,e), genel sağlık değerlendirmesi (f) ve toplam QUALEFFO puanları düşük (p0,05); zihinsel işlev (g) değerlendirme puanı ise yüksek bulundu (p0,05). Tedavi alan grupda yaşam kalite dizininde yeralan fiziksel işlev “b” ve “c” skorları ile “IBF-1” arasındaki ilişki olumsuz idi(p0,05). Tedavi edilen olguların yaşam kalite dizin skorları ile tedavi süresi incelendi- ğinde; fiziksel işlev skoru “a,b,c,d” ve genel sağlık skoru “f” ile tedavi süresi arasında olumsuz ilişki saptandı (p0,05). Sonuç: Osteoporotik vertebral kırıklı olgularda teriparatid tedavisinin kemik formasyon belirteçlerinde artış sağladığı, yaşam kalitesini olumlu yönde etkilediği ve bu durumun tedavi süresiyle ilişkili olduğu saptanmıştır

Reliability and validity of the Turkish version of the New Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire

Purpose: This study aims to adapt and validate the Cleveland Clinic Colorectal Cancer Quality of Life Questionnaire (CCF-CaQL) in Turkish, addressing the significant need for reliable, language-specific QoL measures for colorectal cancer (CRC) in Turkiye. This effort fills a critical gap in CRC patient care, enhancing both patient-provider communication and disease-specific QoL assessment. Methods: The CCF-CaQL was translated into Turkish, verified for accuracy, and reviewed for clarity and relevance. Eligible patients who underwent colorectal surgery for cancer between July 2021 and July 2022 from six hospitals completed the CCF-CaQL and SF-36 questionnaires. For analysis, confirmatory factor analysis using Smart PLS 4 and descriptive statistics were employed. The questionnaire’s reliability and validity were assessed using Cronbach alpha, composite reliability, and the heterotrait-monotrait (HTMT) ratio, along with multicollinearity checks and factor loadings. Nonparametric resampling was used for precise error and confidence interval calculations, and the Spearman coefficient and split-half method were applied for reliability testing. Results: In the study involving 244 colorectal cancer patients, confirmatory factor analysis of the CCF-CaQL indicated effective item performance, with one item removed due to lower factor loading. The questionnaire exhibited high internal consistency, evidenced by a Cronbach alpha value of 0.909. Convergent validity was strong, with all average variance extracted (AVE) values exceeding 0.4. Discriminant validity was confirmed with HTMT coefficients below 0.9, and no significant multicollinearity issues were observed (VIF values < 10). Parallel testing with the SF-36 scale demonstrated moderate to very strong correlations, affirming the CCF-CaQL’s comparability in measuring quality of life. Conclusion: The Turkish version of the CCF-CaQL was validated for assessing quality of life in colorectal cancer patients. This validation confirms its reliability and cultural appropriateness for use in Turkiye. The disease-specific nature of the CCF-CaQL makes it a useful tool in clinical and research settings, enhancing patient care by accurately monitoring treatment effects and interventions in the Turkish colorectal cancer patient population