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    Monitoring of renal function using 99mTc-DMSA and 99mTc-DTPA scintigraphy in patients with spinal cord injury
    (Elsevier Doyma Sl, 2012) Tuna, H.; Cermik, T. F.; Tuna, F.
    Aim: The aim of this study was to assess the degree of alterations of renal function by using 99m-technetium dimercaptosuccinic acid (Tc-99m-DMSA) and 99m-technetium diethylenetriaminepentaacetic acid (Tc-99m-DTPA) scintigraphy in spinal cord injury (SCI) patients. Material and methods: Twenty-two consecutive SCI (15 paraplegic and 7 tetraplegic) patients (mean age: 49.1 +/- 13.4 years) who had no urinary symptoms participated in this prospective study. The mean duration of injury was 45.6 +/- 48.8 months before. Sixteen patients had at least one urinary tract infection history. Renal cortical scintigraphy with Tc-99m-DMSA, radionuclide renography with Tc-99m-DTPA and renal ultrasound were performed within 2-week period. Results: Four (18%) patients had serious pathology on their kidneys such as unilateral or bilateral parenchymal scarring and increased background uptake in their renal cortical scintigraphy with Tc-99m-DMSA. Two of them had grade 3-4 pelvicaliceal ectasia on ultrasound. Additionally, 2 of 18 remaining patients had grade 2 pelvicaliceal ectasia on ultrasound. Sixteen (73%) patients had markedly delayed or delayed and decreased functions of one or both of kidneys on radionuclide renography. However, only four patients had grade 2-4 pelvicaliceal ectasia and none of them had a finding of loosening of renal parenchyma. Conclusion: Combined use of renal cortical scintigraphy and radionuclide renography appears to be contributive to renal ultrasound in the long-term follow-up of patients with SCI. Patients with abnormal findings should be closely followed, and early therapeutic interventions may enable lower morbidity and mortality rates in these patients. (C) 2011 Elsevier Espana, S.L. and SEMNIM. All rights reserved.
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    RAPID GERIATRIC ASSESSMENT, PHYSICAL ACTIVITY, AND SLEEP QUALITY IN ADULTS AGED MORE THAN 65 YEARS: A PRELIMINARY STUDY
    (Springer France, 2019) Tuna, Filiz; Ustundag, A.; Can, H. Basak; Tuna, H.
    Objective: (1) To evaluate geriatric syndromes using the Rapid Geriatric Assessment; (2) To investigate possible association of geriatric syndomes with physical activity and sleep quality in adults aged more than 65 years who applied to outpatients physical medicine and rehabilitation clinic. Design: A cross-sectional study. Setting: Outpatient physical medicine and rehabilitation clinic in Edirne, Turkey. Participants: A total of 56 adults (mean aged 69.7 +/- 4.0 (range, 65-80) years, 33 women). Measurements: The Rapid Geriatric Assessment, which includes the FRAIL Questionnaire Screening Tool for frailty, Simplified Nutritional Assessment Questionnaire (SNAQ), SARC-F Screen for Sarcopenia, and Rapid Cognitive Screen (RCS), was used to assess geriatric syndromes. The International Physical Activity Questionnaire (IPAQ) was used to obtain data regarding health-related physical activity. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality during the past month. Results: The mean age of the patients was 69.7 +/- 4.0 years. Of the 56 patients, 12.5% were frail, 50.0% were pre-frail, 35.7% had sarcopenia, 44.6% had a risk of weight loss, 33.9% had dementia, 57.1% were physically inactive, and 53.6% had poor sleep quality. The total FRAIL and SARC-F scores were positively correlated with the global PSQI score (correlation coefficient (r) = 0.300, p < 0.05; r = 0,327, p < 0.05, respectively) and negatively correlated with the total RCS score (r = -0,267, p < 0.05; r = -0,314, p < 0.05, respectively)). The total FRAIL score was positively correlated with the SARC-F score (r = 0.695, p < 0.001), and the concurrence of frailty and sarcopenia in the same patients was 10.7%. The global PSQI score was negatively correlated with the SNAQ score (r = -0.273, p < 0.05). Conclusion: Frailty and sarcopenia were positively correlated with poor sleep quality and negatively correlated with cognition and physical activity. In clinical practice, the Rapid Geriatric Assessment and determination of physical activity level could assist in disability prevention.