The impact of Technetium-99m dimercapto-succinic acid scintigraphy on DNA damage and oxidative stress in children.

BACKGROUND: Technetium-99m-dimercapto succinic acid (Tc-99m DMSA) scintigraphy is a commonly used imaging modality in children with urological abnormalities. The radiopharmaceuticals, which have the effects of ionising radiation, are used in this method. This study aimed to investigate the impact of the Tc-99m DMSA scan on renal oxidative stress and mononuclear leukocyte (MNL) DNA damage. METHODS: Children, who were followed up by paediatric nephrology at Bezmialem Vakif University and underwent Tc-99m DMSA scintigraphy between April 2015 and January 2016 with the indication of detection of renal scars, were included in this study. The exclusion criteria were nephrolithiasis, history of premature birth and recent urinary tract infection 3 months prior to scintigraphy or antibiotic use in the last 1 month. 3 mL heparinised blood samples were obtained just before, immediately after and 1 week after the scintigraphy. MNL DNA damage, total antioxidant status (TAS) and total oxidant status (TOS) were measured in the blood samples. The oxidative stress index (OSI) was calculated. Spot urine samples were obtained from each patient before and within 3 days after performing the scintigraphy. TAS/Creatinine (TAS/Cr), TOS/Creatinine (TOS/Cr) and N-acetyl-glucosaminidase/creatinine (NAG/Cr) levels were measured in the urine samples. RESULTS: Twenty-seven children were evaluated. The values between TAS, TOS and OSI levels in serum samples at baseline, immediately after and 1 week after the scintigraphy (P = .105, P = .913, and P = .721, respectively) showed no statistically significant difference. The levels of TAS/Cr, TOS/Cr, NAG/Cr ratios and OSI, which were evaluated from urine samples before and within 3 days after the scintigraphy scan were also similar (P = .391, P = .543, P = .819 and P = .179, respectively). The levels of DNA damage only increased following scintigraphy scan and decreased a week later (P < .05). CONCLUSIONS: The effect of Tc-99m DMSA scintigraphy is insufficient to create oxidative damage, but it can cause DNA damage via the direct impact of ionising radiation which can be repaired again in a short time.

Assessment of motor development using the Alberta Infant Motor Scale in full-term infants.

The Alberta Infant Motor Scale (AIMS) is a well-known, norm-referenced scale that evaluates the gross motor development of children from birth to 18 months. The aim of the study was to compare the Canadian norms with the AIMS scores of a Turkish sample of infants, and to investigate whether the current reference values of the AIMS are representative for Turkish full-term infants. The study was conducted with 411 Turkish infants of both sexes (195 girls and 216 boys), born with gestational age 38 weeks and older, weighing ≥2500 g at birth. Motor performance of all the cases at different ages were assessed with the AIMS which was used by a physiotherapist. The mean AIMS scores of Turkish infants were compared with the norm values of the original AIMS established in a Canadian sample of infants. The results showed no statistically significant differences between the AIMS scores of Turkish and Canadian infants during the first 18 months of life except at 0- < 1 and 2- < 3 months of age. The AIMS scores were significantly lower in Turkish infants than in Canadian infants at 0- < 1 (p=0.025) and 2- < 3 (p=0.042) months of age. In conclusion, the AIMS can be used in Turkish children to assess gross motor development, especially after 4 months of age. However, this paper was presented as a preliminary study to compare AIMS results between Turkish and Canadian infants, and further studies are needed to realize the Turkish validation of AIMS.