Aim: Radiotherapy is one of the main treatment modalities in childhood cancers,but it is a treatment method that is generally cautious due to its side effects.Central nervous system re-irradiation is the treatment choice that should be applied by considering the benefit-harm balance due to its side effects, especially radionecrosis.In this study, we aimed to report the results of the cases who underwent childhood CNS reirradiation,which is very disadvantageous in terms of toxicity.
Material and Methods: In this study,the data of patients with primary central nervous system neoplasm who received the repeat courses of RT in our department were retrospectively analyzed.Second-course RT is called reirradiation and is defined as prescribing radiotherapy to the field which overlaps with the first radiotherapy area.Data were obtained from patient files and planning system.
Results: Six patients were included in this study.The primary diagnosis of 50% (n=3) of the patients is medulloblastoma.In the first treatment, craniospinal RT was applied to three patients. The median time between diagnosis and recurrence was 19.5(range 11-101) months.The median time between primary and secondary RT was 22(range 7-102) months.The BED3 equivalent of the dose received by the brain stem(BS) due to the first radiotherapy is a median 90(range 80.6-99.2) Gy.The primary RT BS EQD2 dose was median 52.2 (range 50-57)Gy. The median total dose of re-RT is 36 (range 20-50.4)Gy. The median BED3-BS for re-RT is 48.4 (range 11.5 -90) Gy. The median EQD2 brainstem for re-RT is 29 (range 7.2-54) Gy. During the follow-up period, 3 patients died. Three patients are alive at their 7, 12, and 27-month follow-ups and have no health problems related to the primary diagnosis.
Conclusion: Radio necrosis was not detected in any of the living cases in our study. Further studies are needed to select the appropriate patient and radiotherapy technique for reirradiation in pediatric CNS cases.

INTRODUCTION: In this study, we aimed to investigate the frequency of restless legs syndrome (RLS) in patients with and without helicobacter pylori (HP) detected in pathology.
METHODS: This study was carried out prospectively between January-June 2019 with patients who had dyspeptic complaints and underwent upper gastrointestinal endoscopy and biopsy. The frequency of RLS was compared between the two groups by applying a questionnaire to patients with and without HP.
RESULTS: The study was carried out with 96 patients, 72 HP positive and 24 HP negative. Fifty-two of the patients were women (54%) and 44 were men (46%). The mean age of patients was 44. When the positivity of patients in terms of HP was examined, 1+ HP in 24 patients (25%), 2+ HP in 24 patients (25%) and 3 + HP in 24 patients (25%) were detected. 13 patients were diagnosed as RLS with the questionnaires (14%). The average age of these patients was 41. 9 patients were women (69%) and 4 patients were men (31%). Only two of these patients smoked (15%). When patients were classified according to whether they had HP or not, the rate of HBS was 8.3% in patients who were HP negative, while this rate was 12.5% in patients with 1+ HP, 12.5% in patients with 2+ HP and 21% in patients with 3+ HP.
DISCUSSION AND CONCLUSION: In this study, it was shown that the rate of RLS was 14% in patients with dyspeptic complaints who had endoscopy and the rate of RLS increased with HP severity.

INTRODUCTION: The aim of this study is to determine the course of COVID 19 in patients with autoimmune diseases (AD), and to investigate the severity of disease, need for intensive care and mortality in these patients.

METHODS: In this study, 125 patients who had COVİD-19 and were diagnosed with autoimmune disease before, were evaluated retrospectively. Comorbidities, demographics, laboratory findings, rates of mortality, intensive care unit admission, administration of immunosuppressive treatments and length of hospital stay were collected.

RESULTS: All patients had a positive SARS-CoV-2 PCR test. The most common autoimmune diseases were rheumatoid arthritis, Hashimoto's thyroiditis and inflammatory bowel diseases.

DISCUSSION AND CONCLUSION: Our results have shown diabetes mellitus (DM), neutrophil lymphocyte ratio and platelet count were found to be an independent risk factor for mortality in patients with AD.

Elevated liver enzymes are a laboratory finding that we frequently encounter, especially in patients who apply to the internal medicine outpatient clinic with complaints of nausea, vomiting and abdominal pain. When the etiological reasons are examined in patients living in rural areas in our country, it is understood that liver enzyme elevations due to mushroom eating and consumption of raw milk products are seen more.
Coexistence of rare brucella and mushroom poisoning will be explained in our case.

Intracranial germinomas are rare cancers that primarily affect pediatric age group patients making them rarer still in adults.
This report presents a case of a primary intracranial germinoma arising in the pineal region of a 24 year old male. The patient presented with a history of weight loss and progressive vision loss secondary to obstructive hydrocephalus. MRI demonstrated a large enhancing mass lesion in the region of the pineal gland with radiological features suggestive of a germinoma.
Immunohistochemical stains confirmed the histological diagnosis, with positive staining for C-Kit, OCT4 and PLAP.
In summary, this case report highlights that the diagnosis of pineal gland germinoma present in a young male is made by immunohistochemistry and detailed physical examination.