Neuromuscular Diseases and Rehabilitation

Neuromuscular diseases (NMDs) are a heterogeneous group of diseases that are inherited or acquired, resulting from an abnormality in the anterior horn motor cells, peripheral nerves, neuromuscular junctions, or muscles

Evaluation of internal dosimetry methods in nuclear medicine applications

Nükleer tıp uygulamalarında tanı ve tedavi amaçlı birçok radyonüklid kullanılır. Vücuttaki farklı organlar tarafından soğurulan radyasyon dozunun bilinmesi bu uygulamaların risklerinin ve yararlarının değerlendirilebilmesi açısından oldukça önemlidir. İnternal dozimetri vücut içindeki radyonüklidler ile dokuda depo edilen radyasyon enerjisinin uzaysal ve zamansal dağılımı ve miktarının belirlenmesi ile ilgilenir. Nükleer tıpta tiroid kanseri ve hipertiroidi tedavisinde yaygın kullanımı olan I-31 radyoizotopunun yanında, son yıllarda hepatosellüler karsinoma ve nöroendokrin tümör tedavisinde rutin uygulamaya giren Lu-177 ve Y-90 radyoizotopları da başarı ile uygulanmaktadır. Risk değerlendirilmesi açısından, organ doz hesapları Medikal İnternal Radyasyon Dozimetri (MIRD) tarafından belirlenen standart uygulamanın yanısıra, hastaya spesifik olarak kinetik ve anatomik parametrelerin değerlendirilmesi açısından önemlidir. Bu çalışmada internal dozimetri hesaplarında kullanılan metotlar ele alınmış, bu metodlarda farklı yaş ve cinsiyetlerdeki bireyleri temsil eden uygun modeller, matematiksel formulasyonlar ile açıklanmıştır.Many radionuclides are used for diagnostic and therapeutic in nuclear medicine applications. The knowledge of radiation dose absorbed by different organs in the body is critical to evaluate known risks and benefits of these applications. Internal dosimetry deals with the determination of the amount and the spatial and temporal distribution of radiation energy deposited in tissue by radionuclides within the body. Widely used in nuclear medicine in the treatment of thyroid cancer and hyperthyroidism radioisotope I-131, as well as routine practice in recent years into the treatment of hepatocellular carcinoma and neuroendocrine tumor Lu-177 and Y-90 also successfully applied to radioisotopes. In terms of risk assessment, the organ dose calculations Medical Internal Radiation Dosimetry (MIRD), as well as the application of the standard set by the patient-specific parameters in the evaluation of kinetics and anatomy is important. The methods used internal dosimetry calculations in this study are considered and the appropriate models representing individuals of different ages and regardless of gender are described with mathematical formulations

Erişkin Nöromusküler Hastalarda Farklı Yürüme Yardımcılarının Enerji Harcama Düzeyi, Düşme Riski ve Yürüme Parametrelerine Etkisi

This study was designed to investigate the effects of the different walk aides (single cane, bilateral forearm cructh and walker) on the energy expenditure, the risk of falling and gait parameters in patients with adult neuromuscular disease. The study was conducted self-control in 18 patients who are followed with neuromuscular disease diagnosis. Manual Muscle Test for muscle strength, the Rivermead Mobility Index for levels of mobility, Motor Function Assessment scale for motor function level, Trunk Control Test for trunk control of the cases were used as descriptive measurements. The 2-minute walk test for the functional capacity, Time up-go test and story of falling for the falls and risk of falling, four sensors Arm Band "Arm Band Bodysense Wear" Metabolic Holter for energy consumption, Modified Borg scale for fatigue, pulse oximetry for the oxygen saturation and heart rate and "BTS G-Walk" gait analysis system for the pelvis kinematic analysis and gait parameters were used as outcome measures. Outcome measures were performed firstly during normal gait (without walk aides), then during walking with single cane, bileteral forearm cructh and walker randomly. In this patients group, the proximal muscle weakness has been observed as the most important risk factor for falls. It was found that aproximately 90% of the patients are falling during walking, because of inability to stabilize the knee (50%) and tripping (33%) and mostly outside areas (55%). It was found that while walking with single cane per meter energy consumption unchanged compared with normal walking, 21% was increased with bileteral forearm cructh and 40% with a walker. It was observed that the walk aids decreased the walking speed, walking distance and cadence (the number of steps per minute). It was found that all walk aides increased the duration of the walking cycle. When the pelvis kinematic was analysed, there is only significant difference in extansion of pelvis between groups (p<0.05). The most useful (61%), most comfortable (44.4%) and the most preferred (61%) walk aid was determined as single cane by patients and the most safe (55%) was determined as walker. In the decision-making process for walk aid that the patient's biomechanical, physiological and psychosocial needs, expectations, satisfaction and level of independence should be considered to be provided to patients for walkingBu çalışma erişkin nöromusküler hastalarda farklı yürüme yardımcılarının (baston, çift kanedyen ve yürüteç) enerji harcaması, düşme riski ve yürüme parametrelerine etkisinin araştırılması amacıyla planlandı.Çalışma nöromüsküler hastalık tanısı ile takip edilen 18 hasta üzerinde self kontrollü (kendi kendine kontrolllü) olarak yapıldı. Tanımlayıcı ölçümler için olguların kas kuvveti manual kas testi ile, mobilite düzeyi rivermead mobilite indeksi ile, motor fonksiyon düzeyi motor fonksiyon değerlendirme ölçeği ile, gövde kontrolü gövde kontrol testi ile değerlendirildi. Sonuç ölçümlerinin elde edilmesinde fonksiyonel kapasite 2 dakika yürüme testi, düşme ve düşme riski düşme hikayesi ve süreli kalk yürü testi, enerji tüketimi Dört Sensörlü Kol Bandı "Arm Band Bodysense Wear" Metabolik Holter, yorgunluk Modifiye Borg Skalası, oksijen saturasyonu ve nabız Pulse Oksimetre, yürüme parametreleri ve pelvisin kinematik analizi "BTS G-WALK"yürüme analiz sistemi kullanıldı. Sonuç ölçümleri önce normal yürüme (yürüme yardımcısız) sırasında, sonra randomize olarak baston, kanedyen ve yürüteçle yürüme sırasında gerçekleştirildi. Proksimal kas zayıflığının bu hasta grubunda düşmenin en önemli risk faktörü olduğu gözlemlendi. Yaklaşık % 90'ını yürüme aktivitesi sırasında, en çok dizde boşalma(%50) ve ayak takılması (% 33) nedeniyle ve en fazla ev dışı alanlarda (%55) düşme olduğu saptandı. Baston ile yürüme sırasında normal yürümeye göre metre başı harcanan enerji değişmezken, kanedyen %21, yürüteç ile % 40 oranında arttığı bulundu.Yürüme yardımcılarının yürüme hızını, yürüme mesafesi ve kadansı (dakikadaki adım sayısını) azalttığı, yürüme peryodunun ise süresini artırdığı gözlemlendi. Pelvisin kinematiğinde ise istatistiksel olarak sadece pelvisin extansiyonunda gruplar arası anlamlı fark bulundu (p<0.05). Hastalar tarafından en kullanışlı (%61), en rahat (%44.4) ve en çok tercih edilen (%61) yürüme yardımcısının baston, en güvenlinin ise yürüteç (%55) olduğu belirtildi. Yürüme yardımcısına karar verilirken hastanın biomekaniksel, fizyolojik ve psikososyal gereksinimleri, beklentisi, memmuniyeti ve yürüme yardımcısının hastaya sağlayacağı bağımsızlık düzeyi gözönünde bulundurulmalıdır

Validity And Reliability Of Turkish Version Of Start Back Screening Tool

Objectives: The psychosocial factors that may affect the prognosis of patients with low back pain are generally disregarded. The StarT Back Screening Tool can help clinicians to analyze prognostic indicators and the risk associated with outcome by examining physical and psychosocial factors. The aim of this study was to investigate the psychometric properties of the Turkish version of the StarT Back Screening Tool, including cross-cultural adaptation, internal consistency, test-retest reliability, and construct validity. Methods: In this study, 120 patients with non-specific low back pain were included. The Roland Morris Disability Questionnaire, Oswestry Disability Index, Beck Depression Inventory, Tampa Scale for Kinesiophobia, and the StarT Back Screening Tool were administered. One week after the initial testing, the same examiner repeated the tests. Results: The mean age of the patients who participated in the study was 35.54 +/- 12.45 years. Cronbach's alpha coefficients in the analysis of scale reliability were 0.747 for the overall scale and 0.738 for the psychosocial subscale. The test-retest reliability of StarT Back Screening Tool (intraclass correlation coefficient: 0.90-0.93) was found to be excellent. Pearson correlation coefficients for the correlations between the overall StarT Back Screening Tool and the other measures were very good (r=0.678; p<0.001) for the Roland Morris Disability Questionnaire, good (r=0.473; p<0.001) for the Tampa Scale for Kinesiophobia, good (r=0.541; p<0.001) for the Oswestry Disability Index, and moderate (r=0.336; p<0.001) for the Beck Depression Inventory. Conclusion: The Turkish version of the StarT Screening Tool for non-specific back pain was determined to be valid and reliable. A good assessment of both physical and psychosocial factors in symptomatic patients can help clinicians make a thorough prognosis.Wo

The evaluation of urine activity and external dose rate from patients receiving radioiodine therapy for thyroid cancer

The aim of this study was to determine the external dose rate of iodine retention as a function of time in the bodies of thyroid cancer patients during their isolation period in the hospital. Urine samples were collected at 6th, 12th, 18th, 24th h and 2nd, 3rd, 4th, 5th d from 83 patients after oral administration of I-131 and counted. The external dose rates were also simultaneously determined at the same time points. Then, it was expressed as retained radioiodine body activity versus dose rate. Effective half life calculated from urine sample measurements was found as 18.41.8 h within the first 24 h and 642.7 h between 48 and 120 h. According to this results, the external dose rate (20 Sv h(1)), which patients could be discharged, was achieved after 48 h for 3700 and 5550 MBq, and after 72 h for 7400 MBq of I-131 treatments

Cross-cultural adaptation and validation of diabetes-39 in Turkish patients with type 2 diabetes

To translate Diabetes-39 quality of life scale (D-39) into Turkish, to accomplish a cross-cultural adaptation, to demonstrate validity and reliability of Turkish version (D-39-TR). A total of 214 patients with type 2 diabetes were included, with an average age of 52.59 ± 14.83, a female/male ratio of 51/49%. Internal consistency and test–retest reliability were assessed by Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC), respectively. For structural validity, factor analysis was used. The SF-36 was used for convergent validity, and hemoglobin A1c (HbA1c) was used for differential validity. The Cronbach’s alpha coefficient was over 0.70 for all subscales of D-39-TR and it was 0.93 for whole D-39-TR. No problematic items were detected in the scale. The ICC for test–retest reliability was 0.91 (95% CI 0.91–0.94). The test–retest consistency for the total score was r = 0.94, p r=−0.48, p r = 0.31, p p  Turkish version of D-39 is a reliable and valid scale for measuring QoL in patients with type 2 diabetes.IMPLICATIONS FOR REHABILITATIONThe Turkish version of the Diabetes-39 (D-39) is a valid and reliable questionnaire and can be used in patients with type 2 diabetes.The Turkish version of the D-39 offers a useful tool for better identifying quality of life of patients with type 2 diabetes who are at risk for adverse outcomes.The Turkish version of the D-39 can be used to evaluate the effectiveness of attempts to increase quality of life in patients with type 2 diabetes. The Turkish version of the Diabetes-39 (D-39) is a valid and reliable questionnaire and can be used in patients with type 2 diabetes. The Turkish version of the D-39 offers a useful tool for better identifying quality of life of patients with type 2 diabetes who are at risk for adverse outcomes. The Turkish version of the D-39 can be used to evaluate the effectiveness of attempts to increase quality of life in patients with type 2 diabetes.</p

Radiosynthesis and biodistribution of Tc-99m-Sulfamethoxazole: a novel molecule for in-vivo infection imaging

WOS: 000414767200006The aim of this study was to prepare Tc-99m-Sulfamethoxazole complex and evaluate its efficiency as an infection imaging agent. The Sulfamethoxazole was labeled with Tc-99m and its biological efficacy as a potential radio tracer for Staphylococcus aureus infection was investigated in bacterially infected Albino Wistar rats. The radiolabeling yield was found to be 95 +/- 3.07% and remained constant at more than 93 +/- 0.1% even in serum for 240 min after radiolabeling. Tc-99m-Sulfamethoxazole prepared with high yield localized well in the bacterially infected muscle of the rats. Tc-99m-Sulfamethoxazole may be developed as a radiopharmaceutical agent to distinguish infection from inflammation by nuclear imaging.Manisa Celal Bayar University Research Fund [2015-101]The authors are thankful for the financial support from the Manisa Celal Bayar University Research Fund (Contract No. 2015-101)