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Öğe A comparison of respiratory muscle strength, pulmonary function tests and endurance in patients with early and late stage ankylosing spodylitis(2006) Şahin, G.; Guler, H.; Çalikoglu, M.; Sezgin, M.Background: Ankylosing spondylitis (AS) is a multisystemic disease in which pulmonary function is altered owing mainly to the restriction of chest wall involvement. A restrictive ventilatory defect has been extensively reported. This has been suggested to be a consequence of reduced mobility of the thoracic cage. Respiratory function in AS shows a typical restrictive pattern but pulmonary compliance, diffusion capacity, and arterial blood gases are normal. Objective: The objective of the present study was to compare pulmonary function tests (PFT), respiratory muscle strength (MIP, MEP) and endurance (MVV) in early and late AS. Methods: A total of 35 patients (30 males, 5 females) took part, all of whom met the New York criteria for AS. Patients were divided into two groups for the comparison of early (disease duration <10 years, 20 patients) and late (disease duration >10 years, 15 patients) manifestations in pulmonary function tests, respiratory muscle strength and endurance, dyspnea score, chest expansion, and BASFI score. In addition, 21 healthy controls were compared with the AS patients. Measurement of chest expansion was performed in all subjects. Pulmonary function tests were performed by spirometry. Respiratory muscle strength was evaluated by a mouth pressure meter (MPM). Functional status was assessed by BASFI in all AS patients. Results: There was no significant difference in body mass index between the groups. The FVC and FEV1 were significantly lower in late AS (p=0.003, p=0.03, restrictive ventilatory defect ). Chest expansion was significantly lower in late AS (p<0.05). There was no significant difference for MIP or MEP values between late AS, early AS and the controls (p>0.05). Endurance (MVV) was significantly lower in late AS patients (p=0.05). Although the BASFI and dyspnea scores were higher in late AS, they did not reach significant levels. In addition, age was negatively correlated with MIP and MEP in late AS (r=-0.733; p=0.02, r=-0.667; p=0.05). Conclusion: This study demonstrates that FVC and FEV1 (hallmarks of a restrictive pattern), MVV (endurance) and chest expansion are especially involved in long-standing AS. Therefore, improvement of the thoracic cage should be taken into consideration, especially in early AS. These patients should be encouraged to make regular respiratory exercises for preventing the limitation of chest expansion and also improving cardiopulmonary fitness and respiratory endurance. © Springer Medizin Verlag 2006.Öğe Disease activity in rheumatoid arthritis as a predictor of difficult intubation?(Lippincott Williams & Wilkins, 2008) Akkurt, B. Cagla Ozbakis; Guler, H.; Inanoglu, K.; Turhanoglu, A. Dicle; Turhanoglu, S.; Asfuroglu, Z.Background and objectives: Rheumatoid arthritis is a lifelong systemic disease that can affect any Joint with a synovium. Managing intubation in patients with rheumatoid disease is a special challenge in these patients especially if specific joints, which play an important role during intubation, are affected. We aimed to investigate if there was a correlation between the activity and duration of the disease and the commonly used predictors of difficult intubation in rheumatoid arthritis. Methods: Sixty-six patients with the diagnosis of rheumatoid arthritis and 60 control patients were Included in the study. Patient characteristics were recorded. Body mass index, disease activity scores, Mallampati classification, sternomental distance, thyromental distance, inter-incisor distance and atlanto-occipital joint extension were measured for each patient. Every patient was asked to complete the Stanford Health Assessment Questionnaire (HAQ score). Disease activity score (DAS 28 score) including 28 joints was used to assess the activity of the disease. Correlation between the predictors of difficult intubation and activity was assessed and was compared with the control group. Results: Mallampati scores were higher (P = 0.000), sternomental distance (P = 0.005) and inter-incisor distance (P = 0.003) were shorter and also occlusal surface-upper teeth angle (P = 0.000) and mouth corner-tragus line angle were smaller in the rheumatoid arthritis group compared with controls (P = 0.000). We did not observe a correlation between the disease activity scores and the Mallampati score (P = 0.619), sternomental distance (P = 0.195), thyromental distance (P = 0.174), inter-incisor distance (P = 0.764), angle I (P = 0.372) and angle II (P = 0.609). There was no correlation between the HAQ score and the Mallampati score (P = 0.872), sternomental distance (P = 0.455), thyromental distance (P = 0.841), inter-incisor distance (P = 0.162), angle I (P = 0.768) and angle II (P 0.287). There was no correlation between the duration of the disease and the Mallampati score (P = 0.619), sternomental distance (P = 0.505), thyromental distance (P = 0.426), inter-incisor distance (P = 0.813), angle I (P = 0.377) and angle II (P = 0.600). Conclusion: Tests of disease activity and the duration of the disease were not found to be correlated with the predictors of difficult intubation in this study. Thus, performing the predictive tests for difficult intubation especially in patients with very low scores or short disease is recommended.Öğe Effects of habitual knuckle cracking on metacarpal cartilage thickness and grip strength(Elsevier, 2017) Yildizgoren, M. T.; Ekiz, T.; Nizamogullari, S.; Turhanoglu, A. D.; Guler, H.; Ustun, N.; Kara, M.Joint cracking involves a manipulation of the finger joints resulting in an audible crack. This study aimed to determine whether habitual knuckle cracking (KC) leads to an alteration in grip strength and metacarpal head (MH) cartilage thickness. Thirty-five habitual knuckle crackers (cracking their joints >= 5 times/day) (20 M, 15 F, aged 19-27 years) and 35 age-, gender-, and body mass index-matched non-crackers were enrolled in the study. MH cartilage thickness was measured with ultrasound and grip strength was measured with an analog Jamar hand dynamometer. Grip strength was similar between groups (P > 0.05). Habitual knuckle crackers had thicker MH cartilage in the dominant and non-dominant hands than those of the controls (P = 0.038 and P = 0.005, respectively). There was no correlation between MH cartilage thickness and grip strength in both groups (P > 0.05). While habitual KC does not affect handgrip strength, it appears to be associated with increased MH cartilage thickness. (C) 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.Öğe Left ventricular wall function abnormalities in patients with ankylosing spondylitis evaluated by gated myocardial perfusion scintigraphy(Elsevier Science Inc, 2011) Yalcin, H.; Guler, H.; Gunay, E.; Yeral, N.; Turhanoglu, A.; Bolac, E.; Yalcin, F.Background: Ankylosing spondilitis (AS) is a chronic inflammatory disease with prominent inflammation in joints and extraarticular organs. AS patients have approximately two times more risk of mortality than the normal population. One reason for this increase in mortality is increased cardiovascular risk. In this study, we have aimed to evaluate myocardial perfusion and left ventricular function using Tc-99m-MIBI gated myocardial perfusion single photon emission computed tomography (SPECT). Material and methods: The study group consisted of 28 AS patients (19 men, 9 women), and mean age 39.46 +/- 10.98 years. All patients underwent Tc-99m-MIBI gated myocardial perfusion SPECT with the same day protocol. Results: We detected various risk factors including smoking habits in 12, family history of cardiovascular disease in 12, hypertension in 3, hyperlipidemia in 9 patients. We performed a myocardial perfusion SPECT for each patient and found normal perfusion pattern in SPECT images. Out of 28 patients, eight patients had normal perfusion but wall motion abnormalities. Conclusion: We detected that myocardial perfusion is preserved in the patients with AS. However, left ventricular wall motion abnormalities are seen. We concluded that ankylosing spondylitis may be associated with microvascular dysfunction and gated myocardial perfusion scintigraphy could be valuable in AS patients for the evaluation of LV function even if the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score are low and the disease duration shorter. (C) 2010 Elsevier Espana, S.L. and SEMNIM. All rights reserved.Öğe PRECLINICAL ATHEROSCLEROSIS IN PATIENTS WITH ANKYLOSING SPONDYLITIS WITHOUT CLINICALLY EVIDENT CARDIOVASCULAR DISEASE(Bmj Publishing Group, 2014) Turhanoglu, A. D.; Ustun, N.; Kurt, M.; Yagiz, A. E.; Guler, H.[Abstract Not Available]Öğe The relationship between anti-cyclic citrullinated peptide and bone mineral density and radiographic damage in patients with rheumatoid arthritis(Taylor & Francis Ltd, 2008) Guler, H.; Turhanoglu, A. D.; Ozer, B.; Ozer, C.; Balci, A.Objectives: We aimed to investigate the relationship between anti-cyclic citrullinated peptide (anti-CCP) levels and bone mineral density (BMD), bone turnover, and radiographic damage in patients with rheumatoid arthritis (RA). Methods: Eighty patients (68 females, 12 males, mean age 46.50 +/- 14.59 years) with RA were included in the study. Anti-CCP antibodies were measured by enzyme-linked immunosorbent assay (ELISA). Bone turnover was studied by analysing serum levels of C-terminal telopeptide of type I collagen (sCTX, ng/mL), using an enzyme immunoassay. BMD was measured by dual-energy X-ray absorptiometry (DXA). Disease activity was assessed according to the Disease Activity Score that includes 28 joint counts (DAS28). Functional capacity was assessed by the Health Assessment Questionnaire (HAQ). Results: Anti-CCP-positive patients were defined as group 1 and anti-CCP-negative patients as group 2. The mean disease duration was 7.53 +/- 6.27 years in group 1 and 6.25 +/- 6.51 years in group 2. Anti-CCP had a limited negative correlation with lumbar BMD (r=-0.220, p=0.050) and a negative correlation with femoral BMD (r=-0.242, p=0.031). There was no statistically significant correlation between anti-CCP and sCTX values (r=0.117, p=0.301). Sharp scores were significantly higher in anti-CCP-positive than anti-CCP-negative patients (p=0.012), and anti-CCP levels were significantly correlated with Sharp scores (r=0.240, p=0.032). Conclusions: We found that RA patients with higher levels of anti-CCP antibody had lower lumbar and femoral BMD. Anti-CCP levels were also associated with radiographic damage. Therefore, we suggest that anti-CCP may be a determinant of bone loss in patients with RA.Öğe Sclerostin and Dkk-1 in patients with ankylosing spondylitis(Publisaude-Edicoes Medicas Lda, 2014) Ustun, N.; Tok, F.; Kalyoncu, U.; Motor, S.; Yuksel, R.; Yagiz, A. E.; Guler, H.Objective: To determine the serum Dickkopf-related protein 1 (Dkk-1) and sclerostin levels, and their relationship to structural damage and disease activity in patients with ankylosing spondylitis (AS), as well as to compare the serum Dldc-1 and sclerostin levels in patients receiving and not receiving anti-TNF-alpha treatment. Materials and Methods: This cross-sectional study included 44 AS patients and 41 healthy age- and gender-matched controls. Demographic data, disease activity parameters, and Bath AnIcylosing Spondylitis Radiologic Index (BASRI) scores were recorded. Serum Dkk-1 and sclerostin levels were measured using commercially available ELISA. Results: Serum Dkk-1 levels were lower (P > 0.05) and sclerostin levels were significantly lower (P < 0.05) in the AS patients than in the controls. Dkk-1 and sclerostin levels were similar in the patients that did and didn't receive anti-TNF-alpha treatment, and in the patients with active and inactive disease (P > 0.05). There wasn't a correlation between serum Dkk-1 or sclerostin levels, and disease activity indices (P > 0.05). BASRI scores did not correlate with serum Dkk-1 or sclerostin levels (P > 0.05). Discussion: Sclerostin expression is impaired in AS, but this is not the case for Dkk-1. The lack of an association between Dkk-1 or sclerostin levels, and anti-TNF-alpha treatment, disease activity indices, and radiological damage might indicate that neither the Dkk-1 nor sclerostin level induce inflammation and radiological damage in AS patients. Pathologic bone formation in AS might be due to molecular dysfunction of sclerostin and Dkk-1 at the cellular level.Öğe SUBCLINICAL LEFT VENTRICULAR DYSFUNCTION IN PATIENTS WITH ANKYLOSING SPONDYLITIS WITHOUT CLINICALLY EVIDENT CARDIOVASCULAR DISEASE: A TWO-DIMENSIONAL SPECKLE TRACKING ECHOCARDIOGRAPHIC STUDY(Bmj Publishing Group, 2014) Ustun, N.; Kurt, M.; Yagiz, A. E.; Guler, H.; Turhanoglu, A. D.[Abstract Not Available]
