Objective: Both body weight (BW)- and body surface area (BSA)-based dosing regimens have been recommended for growth hormone (rhGH) replacement. The aim was to compare the two regimens to determine if either resulted in inadequate treatment depending on anthropometric factors. Methods: The retrospective study included children diagnosed with idiopathic isolated growth hormone deficiency. BW-based dosing in mcg/kg/day was converted to BSA in mg/m2/day to determine the equivalent amounts of the given rhGH. Those with a BW-to-BSA ratio of more than 1 were allocated to the “relatively over-dosed group”, while the remaining patients with a ratio of less than 1 were assigned to the “relatively under-dosed” group. Patients with a height gain greater than 0.5 standard deviation score (SDS) at the end of one year were classified as the height gain at goal (HAG), whereas those with a height gain of less than 0.5 SDS were assigned as the height gain not at goal (NHAG). Results: The study included 60 patients (18 girls, 30%). Thirty-six (60%) patients were classified as HAG. The ratio of dosing based on BW-to-BSA was positively correlated both with the ages and body mass index (BMI) levels of the patients, leveling off at the age of 11 at a BMI of 18 kg/m2. The relative dose estimations (over- and under-dosed groups) differed significantly between the patients classified as HAG or NHAG. Fifty-six percent of NHAG compared to 44% of HAG patients received relatively higher doses, while 79% of HAG compared to 21% of NHAG received relatively lower doses (p=0.006). When the patients were subdivided according to their pubertal status, higher doses were administrated mostly to the pubertal patients in both the NHAG and HAG groups. In the pre-pubertal age group, 73% of NHAG compared to 27% of HAG received relatively higher doses, while 25% of NHAG compared to 75% of HAG received relatively lower doses (p=0.01). Conclusion: Dosing based on BW may be preferable in both prepubertal and pubertal children who do not show adequate growth responses. In prepubertal children, relatively lower doses calculated based on BW rather than BSA provide similar efficacy at lower costs.

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Objective: The authors of this study took part in a screening program in schools in Aydın province (unpublished study). This study assessed the final thyroid pathologies of these children with pathology detected during ultrasonography (USG) screening obtained as part of the screening program. Methods: A handheld wireless point-of-care USG device was used to screen the thyroid gland. Children with thyroid pathology were invited to the hospital where detailed lab study and an USG was examined. The study obtained the thyroid measurements, parenchymal features, and noted the presence of nodules in the detailed USG examination. Nodules were classified according to the Thyroid Imaging Reporting & Data System (TI-RADS™) and an USG-guided fine needle aspiration (FNA) was performed according to TI-RADS. Results: A total of 1,553 cases from 21 schools between the ages of 6-17 were evaluated in the screening program. Thyroid pathology was detected in 176 (11.3%) cases. One hundred twenty of 176 patients’ families agreed to attend our centre for further examination, where pathology was confirmed in 108 (90.0%) of the 120 cases. Among the 108 thyroid USG pathologies, 52 (48.1%) patients had a nodule and thyroiditis; 28 (25.9%) patients had only a nodule; 28 (25.9%) patients had only thyroiditis. Thyroiditis was present in 74.0% (n=80) of the cases, of those cases 56.3% (n=45) had peripheral thyroiditis, 31.3% (n=25) had diffuse thyroiditis and 12.5% (n=10) had overweight-related changes. Nodules were present in 73.4% (n=80) of the cases. A total of 9 USG-guided FNA were performed, and their pathology results were as followed; 55.6% (n=5) benign cytology, 11.1% (n=1) follicular adenoma, 11.1% (n=1) atypia of indeterminate significance, 11.1% (n=1) non-diagnostic cytology and 11.1% (n=1) papillary thyroid cancer. Conclusion: This study showed that thyroiditis and nodules in the thyroid gland are common disorders in children. Thyroid nodules may also have a high malignancy potential and the chance of early diagnosis of thyroid cancers with screening is demonstrated.