BACKGROUND The objective of this study was to evaluate local control and patterns of failure in pediatric patients with low‐grade glioma (LGG) who received treatment with intensity‐modulated radiation therapy (IMRT). METHODS In total, 39 children received IMRT after incomplete resection or disease progression. Three methods of target delineation were used. The first was to delineate the gross tumor volume (GTV) and add a 1‐cm margin to create the clinical target volume (CTV) (Method 1; n = 19). The second was to add a 0.5‐cm margin around the GTV to create the CTV (Method 2; n = 6). The prescribed dose to the GTV was the same as dose to the CTV for both Methods 1 and 2 (median, 50.4 grays [Gy]). The final method was dose painting, in which a GTV was delineated with a second target volume (2TV) created by adding 1 cm to the GTV (Method 3; n = 14). Different doses were prescribed to the GTV (median, 50.4 Gy) and the 2TV (median, 41.4 Gy). RESULTS The 8‐year progression‐free and overall survival rates were 78.2% and 93.7%, respectively. Seven failures occurred, all of which were local in the high‐dose (≥95%) region of the IMRT field. On multivariate analysis, age ≤5 years at time of IMRT had a detrimental impact on progression‐free survival. CONCLUSIONS IMRT provided local control rates comparable to those provided by 2‐dimensional and 3‐dimensional radiotherapy. Margins ≥1 cm added to the GTV may not be necessary, because excellent local control was achieved by adding a 0.5‐cm margin (Method 2) and by dose painting (Method 3). Cancer 2013;119:2654–2659. © 2013 American Cancer Society.

Objectives: The aim of this study was to compare the effectiveness of conventional physical therapy (transcutaneous electrical nerve stimulation, hot pack, and therapeutic ultrasound) and extracorporeal shock wave therapy (ESWT) on pain, disability, functional status, and depression in patients with chronic low back pain (LBP). Patients and methods: Ninety-one patients with chronic LBP were included in the study and randomized to groups that received ESWT or conventional physiotherapy; of these, 70 completed the study (37 males, 33 females; mean age: 46.4±13.3 years; range, 18 to 65 years). Outcome measures included the Visual Analog Scale, the pressure pain algometer, Oswestry Disability Index (ODI), Health Assessment Questionnaire (HAQ), fingertip-to-floor distance, and the Beck Depression Inventory. The assessments were made before treatment and at the first and 12th weeks after treatment. Results: Extracorporeal shock wave therapy was more effective than conventional physical therapy in terms of Visual Analog Scale scores, the pressure algometer, ODI, HAQ, and fingertip-to-floor distance at the first and 12th week. Conclusion: Extracorporeal shock wave therapy is superior to conventional physical therapy in terms of improving pain, spinal mobility, and functional status in patients with chronic LBP.

Objective: The aim of this study is to evaluate the sleep quality and relationship between the sleep quality with disease-related variables, pain, functional status, radiological damage and the psychological status in patients with Osteoarthritis (OA). Methods:Fifty two patients diagnosed with OA and 35 healthy control subjects were enrolled in the study. The demographic characteristics of the patients such as age, education level, and marital status were recorded. Disease related disability were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Generalized pain, generalized fatigue and knee pain were assessed with the Visual Analogue Scale (VAS). Psychological status were evaluated with the Hospital Anxiety Depression Scale. The radiological grade of knee OA was evaluated according to the Kellgren Lawrence score. For the evaluation of the sleep quality, the OA and control groups were assessed with the help of the Pittsburgh Sleep Quality Index (PSQI). Results:The patients with OA had significantly higher scores in the subjective sleep quality, sleep latency, habitual sleep efficiency and total PSQI score compared to the healthy control group (p<0.05). According to the results of Spearman's analysis, there was a significantly correlation between the total PSQI score with age, generalized pain, knee pain, WOMAC pain, radiological damage and depressive symptoms (p<0.05). Conclusions:The sleep quality is disturbed in patients with OA. Lower quality of sleep is especially associated with the pain, radiological damage and depressive symptoms. J Clin Exp Invest 2013; 4 (2): 189-194Key words: Knee osteoarthritis, sleep quality, pain, radiological grade, depression ÖZET Amaç: Bu çalışmanın amacı diz osteoartriti (OA) tanılı hastalarda uyku kalitesini değerlendirmek ve uyku kalitesi ile klinik parametreler, ağrı, fonksiyonel durum, radyolojik hasar ve psikolojik durum arasındaki ilişkiyi incelemektir.Yöntemler: Diz osteoartriti tanılı 52 hasta ve 35 sağlık-lı gönüllü çalışmaya dahil edildi. Hastaların yaş, eğitim seviyesi, medeni durumu gibi demografik özellikleri kaydedildi. Hastalıkla ilişkili yeti yitimi, Western Ontario ve McMaster Üniversitesi Osteoartrit indeksi (WOMAC) ile değerlendirildi. Genel ağrı, genel yorgunluk ve diz ağrısı seviyesi görsel analog skala ile değerlendirildi. Psikolojik durum hastane anksiyete depresyon skalası ile ölçüldü. Diz osteoartritinin radyolojik evresi Kellgren Lawrence skoruna göre hesaplandı. Hasta ve kontrol grubunun uyku kalitesi, Pittsburgh uyku kalitesi indeksi (PUKİ) yardımıyla değerlendirildi.Bulgular: Diz osteoartriti olan hastalarda, öznel uyku kalitesi, uykuya dalma süresi, alışılmış uyku etkinliği ve total PUKİ skoru kontrol grubuna göre anlamlı olarak yüksekti (p<0,05). Spearman analizi sonuçlarına göre, total PUKİ skoru ile yaş, yaygın ağrı, diz ağrısı, WOMAC ağrı, radyolojik evre ve depresif semptomlar arasında anlamlı korelasyonlar saptandı (p<0,05).Sonuç: Diz OA tanılı hastalarda uyku kalitesi bozulmaktadır. Bozulmuş uy...

In the present study, patients with an active disease had significantly higher serum HNP 1-3 levels compared to patients in remission. In this respect, serum HNP 1-3 can be a useful marker in the assessment of disease activity and remission in patients with RA.

Background/aim: Nailfold video capillaroscopy is considered as a reliable method for evaluating peripheral microangiopathy in rheumatologic diseases. In this study, we aimed to demonstrate the utility of handheld dermatoscopy as an easy-to-use nailfold capillaroscopic instrument in patients with rheumatoid arthritis.Materials and methods: This cross-sectional study included patients with rheumatoid arthritis and healthy subjects. A handheld dermatoscopic examination of proximal nail fold was performed in each subject. The possible correlation of capillaroscopic findings with disease activity was evaluated using the disease activity score 28 (DAS28).Results: A total of 59 patients with rheumatoid arthritis and 60 healthy subjects were enrolled in the study. The presence of capillaryenlargement, avascular areas, capillary deformities, and capillary vascular anomalies in the group of patients showed a statistically significant difference when compared with the healthy subjects. No correlation was found between the nail fold capillaroscopic findings and DAS28 score.Conclusion: Hand-held dermatoscopy seems to be a useful technique in the evaluation of nail fold capillary changes. We suggest that in patients with rheumatoid arthritis, when capillaroscopic examination is needed, it can be evaluated using handheld dermatoscopy. Selected patients who showed findings using this method can be further examined with classical capillaroscopy to obtain more quantitative data.

Our study showed that US does not have any benefits on SIS. TENS + exercise program are not effective on anxiety, depression and fatigue, however TENS +$ exercise program are effective on pain, disability and sleep disturbance in patients with SIS.

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Bisphosphonates are commonly used in the treatment of osteoporosis. Atypical femoral fracture (AFF) is a well-known adverse effect of bisphosphonate use. The importance of genetic factors has been demonstrated in bone quality, bone turnover, and in the response to osteoporosis treatment. Herein, we present two cases of bilateral AFFs after bisphosphonate use for a short period of time in members of the same family (mother and her daughter) and discuss genetic predisposition to bisphosphonate-induced AFFs in the light of literature data.