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Assessment of the Relationship Between Bone Mineral Density and Disease Activity in Ankylosing Spondylitis Patients with Osteopenia
(Galenos Yayincilik, 2013) Guler, Hayal; Ustun, Nilgun; Bolac, Veli Enes; Yagiz, Abdullah Erman; Mansuroglu, Ayhan; Yengil, Erhan; Turhanoglu, Ayse Dicle
Aim: Ankylosing Spondylitis (AS) is a chronic inflammatory disease. Spinal osteopenia is common in AS, probably due to immobility and local cytokine release. In this study, we evaluated the relationship between bone mineral density and disease activity in Ankylosing Spondylitis patients with osteopenia. Material and Methods: Sixty one AS patients (26F, 35M) were enrolled in this study. The disease duration, morning stiffness, Schober tests, Erythrocyte Sedimentation Rate (ESR) and C Reactive Protein (CRP) were analyzed and recorded. Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Bone mineral density (BMD) was measured by using GE/LUNAR DPX PRO equipment. Results: The mean age and disease duration of the patients were 38.67 +/- 10.81 and 7.87 +/- 7.09 year. There was osteopenia in 34 (% 55.7) patients. Spine and femur BMD values of this patients were 1.03 +/- 0.16 and 0.88 +/- 0.09. BMD measurements of 27 (% 44.3) patient were found normally. Spine and femur BMD values of this patients were 1.20 +/- 0.11 and 1.11 +/- 0.15. There was not statistically significant difference between osteopenia and normal group in ESR, CRP, and BASDAI values (p>0.05). There was not correlation between BMD values and ESR, CRP, and BASDAI values in osteopenia group (p>0.05). Conclusion: In our study, we did not find relationship between bone mineral density and disease activity in AS patients with osteopenia.
Assessment of the Relationship between Physical Activity Levels and Isokinetic Muscle Performance
(Galenos Yayincilik, 2016) Micoogullari, Ahmet; Yildizgoren, Mustafa Turgut; Turhanoglu, Ayse Dicle; Ustun, Nilgun; Guler, Hayal
Objective: To evaluate the association between physical activity levels and isokinetic muscle strength of knee. Materials and Methods: Thirty amateur athletes and 30 healthy volunters (aged between 20-24) were included in the study. Participants were divided into two groups as amateur athletes (group 1) and healthy controls (group 2). Physical activity levels of the participants were assessed by International Physical Activity Questionnaire (IPAQ). Dominant knee flexion and extension muscle strength of the participants were measured with an isokinetic dynamometer at 60 degrees/s and 180 degrees/s angular velocities. Results: There were no statistically significant difference between the groups in age, sex, weight, height, body mass index and, smoking status (p>0.05). There was a statistically significant difference in IPA scores between the groups (p<0.05). IPAQ scores were higher in group1I. There were no statistically significant difference between the knee extensor and flexor peak torque values in both groups (p>0.05). Group 1 was divided into subgroups according to IPA scores. In patients with high activity level, peak torque values at the angular velocities of 60 degrees/s and 180 degrees/s for knee muscles were significiantly higher (p<0.05). Conclusion: Further studies that evaluating of the many factors that determining and affecting muscle strength are with larger groups will be beneficial.
CAN FOOT PAIN AND MUSCULOSKELETAL DISORDERS BE COUNTED AS RISK FACTORS FOR FALLS IN THE ELDERLY?
(Gunes Kitabevi Ltd Sti, 2010) Turhanoglu, Ayse Dicle; Guler, Hayal; Kalici, Aydiner; Inanoglu, Deniz; Ozer, Cahit
Introduction: In this study, it was aimed to determine whether musculoskeletal disorders (FMDs) and/or foot pain (FP) were risk factors for falls and deteriorating health status in the elderly. Materials and Method: Two hundred fifty five patients aged over 60 years were enrolled in the study. The elderly filled the questionnaire about FP and falling. The FMDs in the study included hallux valgus (HV), hammer toe (HT), mallet toe (MT), claw toe (CT), overlapping toe (OT), pes cavus (PC), pes planus (PP), metatarsalgia (MA) and plantar fasciitis (PF). Participants' risk of falling was assessed using The Performance-Oriented-Mobility-Assessment and the health status was measured using The Short-Form (SF)-36. Results: A total of 255 patients with a mean age of 67.90 +/- 6.15 were examined; 175(69%) were female and 78 (31%) were male. Ninety-seven (38%) of the subjects reported FP and 103 (43.8%) patients were diagnosed as having FMDs. The most common FMD was HV (18.4%), followed by PF (15.9%), PP (13.3%), MA (12.9%), HT (7.8%), MT (4.3%), OT (3.5%), CT (1.6%) and PC (1.9%). FP, HV, PP, MA, PF, CT and OT were associated with risk of falling (p<0.05). There was a relationship between falls and the presence of FMD (p<0.01) and foot pain (p<0.01). PCSs of the patients with FP were lower than that of those without FP (p<0.05) Conclusion: FMDs and FP should be considered as risk factors for falling in the elderly.
Comparison of Ketoprofen Phonophoresis with Ketoprofen and Lidocaine-Prilocaine Phonophoresis in Patients with Subacromial Impingement Syndrome
(Turkish League Against Rheumatism, 2009) Guler, Hayal; Turhanoglu, Ayse Dicle; Inanoglu, Kerem; Inanoglu, Deniz; Ozer, Cahit
Objective: The aim of the present study was to compare ketoprofen phonophoresis with ketoprofen and lidocaine-prilocaine phonophoresis in patients with subacromial impingement syndrome (SIS). Material and Methods: Seventy patients (39 female, 31 male) with SIS were included in this study. The patients were divided into two groups and a 15-session physical therapy and rehabilitation program was performed in each group. Ketoprofen and lidocaine-prilocaine phonophoresis were performed in the first group and ketoprofen phonophoresis alone in the second group. Hot pack, transcutaneous electrical nerve stimulation (TENS) and exercises were applied in all patients. Severity of shoulder pain was determined by visual analogue scale (VAS). Range of motion (ROM) was measured by goniometer. Functional capacity of patients was evaluated by UCLA (The University of California-Los Angeles) score. All of the measurements were performed before treatment and in the 1st and 3rd months after treatment. Results: There was no significant difference between the two groups in VAS and UCLA scores before treatment initiation (p>0.05). VAS scores of Group 1 were lower than of Group 2 (p=0.020) in the 3rd month follow-up. ROMs and flexion, abduction and internal rotation were higher in Group 2 than Group 1 (p=0.009, p=0.001, p=0.019, respectively) before treatment. Abduction measurements in Group 2 were higher than in Group 1 in the 1st month after treatment (p=0.024). However, there was no significant difference between the two groups in UCLA and ROM values in the 3rd month (p>0.05). There was also no significant difference between the two groups in external rotation values before and after treatment (p>0.05). Conclusion: Our study showed that ketoprofen and lidocaine-prilocaine phonophoresis were more effective on pain and ROM than ketoprofen phonophoresis alone in the 3rd month after treatment in patients with SIS. (Turk J Rheumatol 2009; 24: 88-93)
Conservative Treatment of Achilles Tendinosis, and Importance of Ultrasonography in The Follow-Up: A Case Report
(Galenos Yayincilik, 2015) Yildizgoren, Mustafa Turgut; Osmanoglu, Kasim; Ustun, Nilgun; Guler, Hayal; Turhanoglu, Ayse Dicle
Achilles tendinopathy is a painful condition that often develops as a result of overloading to tendon. There are many factors in etiology like tendon ischemia, micro-tears and metabolic events. Non-insertional tendon region of the Achilles tendon that has poor vascularity is a common localization for tendinopathy. In this paper, we presented a 55 year old man, who had pain and swelling in the right heel and we discussed the importance of ultrasound.
Diabetic Radiculoplexus Neuropathy Involving the Upper Extremity: A Case Report
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2010) Turhanoglu, Ayse Dicle; Guler, Hayal; Okuyucu, Esra; Kizil, Nurhan
Diabetic radiculoplexus neuropathy is a relatively rare condition, in which unilateral or bilateral muscular weakness that acutely or subacutely develops mainly around the hip in type 2 diabetes patients. A 71-year-old man with diabetes mellitus presented with asymmetrical weakness and atrophy of the right shoulder girdle muscles for the last 3 months. He had limitation of right shoulder range of motions and could not raise his right arm. Our patient, who fulfilled the criteria for the diagnosis of diabetic radiculoplexus neuropathy based on clinical and electrodiagnostic features, is reported and discussed in the light of the literature. Turk J Phys Med Rehab 2010;56:148-51.
Diffuse Idiopathic Skeletal Hyperostosis with Cervical Vertebra Involvement: A Case Report
(Galenos Yayincilik, 2021) Arslan, Mehmet; Ogut, Halil; Guler, Hayal; Turhanoglu, Ayse Dicle
Diffuse idiopathic skeletal hyperostosis is a non-inflammatory disease characterized by ossification and calcification in soft tissues, such as enthesis and joint capsules. The thoracic vertebra is often affected; however, cervical vertebra involvement can also be seen. Diagnosis is made by observing ossifications in the anterior surface of the four vertebrae and excluding spinal degenerative and inflammatory diseases. Pain and movement limitation is frequently observed in cervical vertebra involvement, but symptoms, such as dysphagia, hoarseness, and snoring, may also occur. This study aimed to present a 69-year-old male patient with pain in the neck and back, movement limitations, and swallowing difficulties, mostly with solid foods. The cervical imaging of the patient revealed anterior ossifications that compress the esophagus and posterior ossifications without myelomalacia. Surgery was recommended to the patient for his progressive dysphagia but was refused. Partial improvement was achieved in the patient's complaints with exercise and swallowing training in pain, movement limitation, and swallowing difficulties.
The Effect of Anti-Tumor Necrosis Factor-Alpha Treatment on Muscle Performance and Endurance in Patients With Ankylosing Spondylitis: A Prospective Follow-Up Study
(Turkish League Against Rheumatism, 2017) Demirkapi, Musa; Yildizgoren, Mustafa Turgut; Guler, Hayal; Turhanoglu, Ayse Dicle
Objectives: This study aims to evaluate muscle performance by using isokinetic dynamometer before and at third month of anti-tumor necrosis factor-alpha treatment in ankylosing spondylitis patients. Patients and methods: Thirty ankylosing spondylitis patients (23 males, 7 females; mean age 39.3 +/- 8.6 years; range 18 to 45 years) starting on antitumor necrosis factor-alpha treatment and 30 healthy controls (23 males, 7 females; mean age 39.1 +/- 8.8 years; range 18 to 48 years) with similar age, body mass index, and sex were enrolled. The clinical anthropometric measurements of chest expansion, lumbar Schober test, hand-finger floor distance and visual analog scale-global, C-reactive protein, erythrocyte sedimentation rate, Ankylosing Spondylitis Disease Activity Score-C-reactive protein and Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Metrology Index were determined before and at third month of the treatment. Results: There was no statistically significant difference in age, sex and, body mass index between the groups (p>0.05). A statistically significant difference was detected between 60 degrees/second and 180 degrees/second peak torque in angular velocity of flexor and extensor muscles (p<0.05). A significant difference was detected in respect to total work of patients with 180 degrees/second peak torque in angular velocity of flexor and extensor muscles (p<0.05). There was a statistically significant difference between the findings of 60 degrees/second and 180 degrees/second peak torque in angular velocity of flexor and extensor muscles (p<0.05). Isokinetic test results were better at third month after treatment than before treatment. Conclusion: The results of this study showed that both functional limitations and performance and endurance of muscles may be improved with anti-tumor necrosis factor-alpha treatment in ankylosing spondylitis patients.
Effect of Coexisting Foot Deformity on Disability in Women with Knee Osteoarthritis
(Amer Podiatric Med Assoc, 2009) Guler, Hayal; Karazincir, Sinem; Dicle Turhanoglu, Ayse; Sahin, Gunsah; Bald, Ali; Ozer, Cahit
Background: Knee osteoarthritis, a common musculoskeletal disorder, can cause considerable pain and disability. This study investigates the effect of certain foot deformities on the functional status of women with knee osteoarthritis. Methods: The common foot deformities pes planus and hallux valgus were evaluated in 115 women with knee osteoarthritis and Kellgren-Lawrence grade 2 and 3 osteoarthritis. Anteroposterior and lateral foot-ankle standard radiographs were obtained bilaterally. A lateral talometatarsal angle greater than 4 degrees was defined as pes planus. A hallux valgus angle greater than 21 degrees was defined as hallux valgus. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to objectively assess functional impairment. Knee pain intensity was measured with a visual analog scale. Results: Fifty-nine patients had bilateral pes planus, hallux valgus, or both. The mean visual analog scale value was higher for the deformity group, but the difference was not statistically significant. There was a significant difference in WOMAC scores between the group with foot deformities versus the group without (P = .000). Visual analog scale scores were positively correlated with WOMAC scores (r = 0.499, P = .000). Also, there was a significant correlation between WOMAC scores and lateral talometatarsal angle (r = 0.266, P = .004) and hallux valgus angle (r = 0.362, P = .000) values. Conclusions: There is a significant correlation between indicators of pain and disability (visual analog scale and WOMAC scores). Also, the presence of foot deformities increased disability levels in women with knee osteoarthritis. (J Am Podiatr Med Assoc 99(1): 23-27, 2009)
The effect of oral baclofen and botulinum toxin treatments in hemiplegic spasticity on the nociceptive flexor reflex: A randomized clinical trial
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2022) Gunturk, Erturk; Ogut, Halil; Guler, Hayal; Turhanoglu, Ayse Dicle
Objectives: This study aimed to analyze the effect of oral baclofen treatment and botulinum toxin type A (BT-A) injection treatment in hemiplegic patients with spasticity on the electromyographic nociceptive flexor reflex (NFR) threshold. Patients and methods: A total of 29 spastic hemiplegic patients (20 males, 9 females; mean age: 52.9 +/- 10.1; range, 27 to 64) with Modified Ashworth Scale (MAS) grades 2-4 were included in the prospective, randomized study between May 2018 and March 2019. The patients were divided into two groups: the BT-A group consisted of 15 patients that underwent a BT-A injection and the baclofen group consisted of 14 patients treated with baclofen. Modified Ashworth Scale, Visual Analog Scale (VAS), Barthel daily life activity index, and NFR threshold values were used in the evaluation of the patients before and after the treatment at the sixth week. The motor evaluation of the patients was performed using Brunnstrom motor staging. Results: In both groups, MAS and VAS values decreased significantly compared to pretreatment (p<0.05). There was a significant decrease in ankle MAS score (p<0.001) and a significant increase in Brunnstrom hand recovery stages in the BT-A group compared to pretreatment (p=0.020). While the NFR threshold statistically significantly increased in the baclofen group compared to pretreatment (p=0.007), there was no significant change in the BT-A group (p=0.669). Conclusion: These results suggest that BT-A injections do not cause a significant change in the NFR threshold in the treatment of spasticity.
Effects of a rehabilitation program for Parkinson's patients on reaction and movement time: an electromyographic study
(Cukurova Univ, Fac Medicine, 2022) Kizil, Nurhan; Ogut, Halil; Okuyucu, Esra; Guler, Hayal; Ozer, Cahit; Turhanoglu, Ayse Dicle
Purpose: The aim of the study was to investigate the effects of a rehabilitation program consisting of specific exercises for Parkinson's Disease (PD) patients on reaction time (RT), movement time (MT), quality of life and disease activity. Materials and Methods: A total of 26 idiopathic PD patients were included in the study. The exercises specific to Parkinson's were applied to the patients for 16 weeks. The evaluation of the patients were done before and after the treatment. The disease severity was measured with Unified Parkinson's Disease Rating Scale (UPDRS), quality of life was measured with Short Form-36 (SF-36). RT and MT measurements were done electromyographically. Results: There was no statistically significant difference in UPDRS total and sub-section values and SF-36 quality of life evaluation before and after the exercise program. While a significant decrease was observed in the RT values of the patients after the 16 week exercise program compared to prior to the program (Deltoid RT 370.46 +/- 25 to 219.58 +/- 17, biceps RT 370.42 +/- 27 to 216.49 +/- 14 and triceps RT 445.21 +/- 31 to 247.53 +/- 23, respectively). Conclusion: In PD, the rehabilitation program specific to the disease leads to a significant decrease in RT. Although the exercise has no statistically significant effect on disease activity, quality of life and MT values, it was seen that it still led to improvement.
Effects of radial extracorporeal shock wave therapy on clinical variables and isokinetic performance in patients with knee osteoarthritis: a prospective, randomized, single-blind and controlled trial
(Springer, 2020) Uysal, Alper; Yildizgoren, Mustafa Turgut; Guler, Hayal; Turhanoglu, Ayse Dicle
Objective This study aims to compare the efficacy of r-ESWT treatment with sham-ESWT on pain, walking speed, physical function, and isokinetic muscle strength in knee osteoarthritis. Methods The study included 104 patients (mean age 61.0 +/- 6.2 years; range 50 to 70 years) who were admitted to our outpatient clinic with newly diagnosed with knee osteoarthritis. Patients were randomly assigned to two groups. Both groups received transcutaneous electrical nerve stimulation for 30 minutes, hot pack for 40 minutes, and home-based exercise program of around the knee strengthening for 30 minutes in a day for three weeks (5 days in a week). Also, one group was treated with r-ESWT, while the other group was treated with sham-ESWT. For r-ESWT, patients received 2000 pulses of shockwave at 2.0 to 3.0 bar weekly for three weeks. All patients were evaluated with visual analog scale (VAS), active knee range of motion (ROM), 20-metre walk test, Western Ontario and McMaster Osteoarthritis Index (WOMAC), Lequesne's disability index, and isokinetic muscle performance before treatment, at the end of treatment, at one month and three months after treatment. Results When groups were compared, group 1 scores were significantly better than the group 2 in all outcome parameters except WOMAC-stiffness at the end of treatment, at one month and three month follow-up (all p < 0.05). The VAS-resting, VAS-movement, knee ROM, 20-m walk test, WOMAC, and Lequesne's disability scores and peak torque values of knee extension improved in both groups with the highest improvement in the r-ESWT group. A comparison of difference of the two group scores showed statistically significant superior improvement in group 1 in all parameters at both one month and three months. Conclusion Our findings revealed that r-ESWT combined with conventional electrotherapy is an effective treatment for improving pain and physical function in knee osteoarthritis to control symptoms up to three months.
Efficacy of EMLA cream phonophoresis comparison with ultrasound therapy on myofascial pain syndrome of the trapezius: a single-blind, randomized clinical study
(Springer Heidelberg, 2014) Ustun, Nilgun; Arslan, Fatma; Mansuroglu, Ayhan; Inanoglu, Deniz; Yagiz, Abdullah Erman; Guler, Hayal; Turhanoglu, Ayse Dicle
The aim of this study is to investigate whether eutectic mixture of local anesthetics (EMLA) cream phonophoresis superior to conventional US over the trigger points (TPs) in terms of improvements of pain, range of motion and disability in myofascial pain syndrome (MPS). Fifty patients (42 female, 8 male) diagnosed with MPS were included in the study. Patients were randomly assigned into two treatment groups including phonophoresis (PH) group (n = 25) and ultrasound (US) group (n = 25). PH group received EMLA cream phonophoresis (2.5 % lidocaine, 2.5 % prilocaine); US group received conventional ultrasound therapy over the all active TPs on trapezius muscle for 10 min a day for 15 sessions. Outcome measures were performed before the treatment course and at the end of a 15-session course of treatment. Student T, Mann-Whitney U, chi-square and Wilcoxon tests were used for statistical analysis. At the end of the therapy, there was statistically significant decrease in both PH group and US group in terms of number of trigger point (NTP) (p = 0.001, p = 0.029), pain intensity on movement (p = 0.001 vs. 0.002) and right/left cervical lateral ROMs (p = 0.001/p = 0.001, p = 0.009/p = 0.020) relative to baseline. The NTP decrease in PH group was significantly higher than that in US group (1.84 +/- A 1.46 vs. 0.72 +/- A 1.45; p = 0.01). Pain intensity at rest (p = 0.001) and NPDI scores (p = 0.001) were statistically improvement in only PH group. EMLA cream phonophoresis is more effective than conventional ultrasound therapy in terms of pain and associated neck disability, and it seems the complementary treatment option for MPS.
The evaluation of early pulmonary involvement with high resolution computerized tomography in asymptomatic and non-smoker patients with rheumatoid arthritis
(Turkish Assoc Tuberculosis & Thorax, 2009) Karazincir, Sinem; Akoglu, Sebahat; Guler, Hayal; Balcı, Ali; Babayigit, Cenk; Egilmez, Ertugrul
To investigate pulmonary involvement by high resolution computerized tomography (HRCT) in patients with rheumatoid arthritis (RA) who are asymptomatic and lifelong non-smoker. Twenty-five patients with RA who are asymptomatic and lifelong non-smoker were included in the study. After clinical and laboratory investigations, plain chest X-rays, pulmonary function tests (PFT) and HRCT were performed. End expiratory HRCT slices were obtained for air trapping. Chest X-ray, PFT and HRCT findings showed 12%, 16%, 48% abnormalities, respectively. Interstitial involvement was the most common finding on HRCT (36%) and followed by air trapping (20%). Bronchiectasis, pulmonary nodule, and pleural disease were seen in 16%, 12%, and 12% of patients, respectively. None of patients had emphysema and honeycomb pattern. There was no statistically significant correlation between HRCT findings and disease activity criteria, RF positivity, PFT results and duration of the disease. Our study shows that pulmonary involvement is not always together with respiratory symptoms and impaired pulmonary function in patients with RA. New studies are needed which investigating the effects of radiologically detected lung involvement on prediction of survival and treatment choice in asymptomatic and nonsmoker RA patients.
Increased Epicardial Fat Tissue Is a Marker of Subclinic Atherosclerosis in Ankylosing Spondylitis
(Turkish League Against Rheumatism, 2014) Ustun, Nilgun; Kurt, Mustafa; Atci, Nesrin; Yagiz, Erman; Guler, Hayal; Turhanoglu, Ayse
Objectives: This study aims to assess subclinical atherosclerosis markers such as epicardial fat thickness, carotid intima media thickness (CIMT), and aortic stiffness index (ASI) in ankylosing spondylitis (AS) patients as well as to investigate the relationship between the subclinical atherosclerosis markers and disease activity/function/mobility indices. Patients and methods: Twenty-six AS patients (22 males, 4 females; mean age 43 years) and 26 age-and sex-matched healthy controls (21 males, 5 females; mean age 43 years) were included. Patients and controls with any reported cardiovascular disease or other comorbidities were excluded. Disease activity, functional capacity and spinal mobility were measured using the Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, and Bath Ankylosing Spondylitis Metrology Index, respectively. All patients underwent complete transthoracic echocardiographic examination including epicardial fat thickness and ASI, and sonographic examination including CIMT. Results: There were no significant differences in demographical and cardiovascular characteristics between AS patients and healthy controls (p>0.05). Epicardial fat thickness (5.15 +/- 1.13 vs. 4.11 +/- 1.22; p=0.003), CIMT (0.70 +/- 0.16 vs. 0.60 +/- 0.10; p=0.012) and ASI (14.2 +/- 10.8 vs. 8.6 +/- 3.1; p=0.018) were significantly increased in patients with AS compared to the healthy controls. There was no significant correlation between the subclinical atherosclerosis markers and disease activity/function/mobility indices (p>0.05). Conclusion: A significantly increased epicardial fat thickness, CIMT, and ASI were observed in AS patients compared with healthy controls.
Left ventricular systolic dysfunction in patients with ankylosing spondylitis without clinically overt cardiovascular disease by speckle tracking echocardiography
(Springer Heidelberg, 2015) Ustun, Nilgun; Kurt, Mustafa; Nacar, Alper Bugra; Karateke, Hacer Paksoy; Guler, Hayal; Turhanoglu, Ayse Dicle
The aim of this study was to evaluate left ventricular systolic and diastolic function using speckle tracking echocardiography (STE) in order to detect subclinical left ventricular dysfunction in patients with ankylosing spondylitis (AS). Twenty-six AS patients (age 43.7 +/- A 11.8 years, disease duration 11.83 +/- A 10.98 years) and 26 healthy controls, matched for age, sex, body mass index, and smoking, were enrolled in this cross-sectional study. All patients underwent two-dimensional, Doppler, tissue Doppler, and speckle tracking echocardiography. The mitral early/late diastolic inflow velocity ratio (1.0 +/- A 0.4 vs. 1.5 +/- A 0.5; p < 0.001) and the mitral E-wave velocity (8.1 +/- A 2 vs. 11.1 +/- A 3; p < 0.001) were lower in the AS patients than in the controls. The ejection fraction did not differ between the patients and controls (64 +/- A 4.2 vs. 64.8 +/- A 2.3; p = 0.402). All segments showed a significant decrease in left ventricular diastolic and systolic strain values in the patients with AS when compared with the healthy controls (p < 0.001). Despite no clinical evidence of cardiovascular disease, patients with AS may have impaired left ventricular systolic function as assessed by STE.
P wave dispersion in patients with rheumatoid arthritis: its relation with clinical and echocardiographic parameters
(Springer, 2007) Guler, Hayal; Seyfeli, Ergun; Sahin, Gunsah; Duru, Mehmet; Akgul, Ferit; Saglam, Hayrettin; Yalcin, Fatih
P wave dispersion (PWD) is a sign for the prediction of atrial fibrillation (AF). The aim of this study was to assess P wave dispersion and its relation with clinical and echocardiographic parameters in patients with rheumatoid arthritis (RA). Thirty RA patients (mean age 49 +/- 10 years) and 27 healthy controls (mean age 47 +/- 8 years) were included in the study. We performed electrocardiography and Doppler echocardiography on patients and controls. Maximum and minimum P wave duration were obtained from electrocardiographic measurements. PWD defined as the difference between maximum and minimum P wave duration was also calculated. Maximum P wave duration and PWD was higher in RA patients than controls (P = 0.031 and P = 0.001, respectively). However, there was no significant difference in minimum P wave duration between the two groups (P = 0.152). There was significant correlation between PWD and disease duration (r = 0.375, P = 0.009) and isovolumetric relaxation time (r = 0.390, P = 0.006). P wave duration and PWD was found to be higher in RA patients than healthy control subjects. PWD is closely associated with disease duration and left ventricular (LV) diastolic dysfunction.
Predictors of Difficult Intubation in Patients With Ankylosing Spondylitis: Do Disease Activity and Spinal Mobility Indices Matter?
(Turkish League Against Rheumatism, 2014) Ustun, Nilgun; Tok, Fatih; Davarci, Isil; Yagiz, Erman; Guler, Hayal; Turhanoglu, Selim; Turhanoglu, Ayse
Objectives: This study aims to determine the predictors of difficult intubation and their possible correlations with disease activity and spinal mobility indices in patients with ankylosing spondylitis. Patients and methods: Forty-five ankylosing spondylitis patients were included in the study. Disease activity was evaluated with the Bath Ankylosing Spondylitis Disease Activity Index and spinal mobility with Bath Ankylosing Spondylitis Metrology Index (BASMI). The predictors of difficult intubation were evaluated by using the modified Mallampati test, upper lip bite test, thyromental distance, sternomental distance, interincisor distance and neck extension. Results: There was no correlation between Bath Ankylosing Spondylitis Disease Activity Index and predictive test values (all p>0.05). There were significant correlations between BASMI with modified Mallampati test, sternomental distance, neck extension, and inter-incisor distance values (all p<0.05). The BASMI scores in patients with two or more predictors were significantly higher than BASMI scores in patients with none or one predictor (5.28 +/- 2.12 vs. 1.58 +/- 1.50; p<0.001). Among the patients with moderate to severe BASMI, the number of patients with two or more predictors was higher than in those patients with none or one predictor (p=0.001). Conclusion: Neck extension, inter-incisor distance, sternomental distance and modified Mallampati test are significant predictors for difficult intubation in patients with ankylosing spondylitis. These predictors were found to be correlated with spinal mobility index, but not with disease activity index. Clinicians should be aware of difficult intubation in ankylosing spondylitis patients with moderate to severe spinal mobility limitation.
Relationship between erector spinae muscle thickness and bone mineral density in postmenopausal women: An ultrasonographic study
(A. CARBONE Editore, 2016) Guler, Hayal; Yildizgoren, Mustafa Turgut; Ustun, Nilgun; Karazincir, Sinem; Balcı, Ali; Ozer, Cahit; Turhanoglu, Ayse Dicle
Introduction: Aging is associated with an increase in the risk of falls and fractures in elderly osteoporotic women in addition to low bone mass and muscle atrophy. We aimed to assess relationship between paraspinal muscle thickness and bone mineral density in postmenopausal women. Materials and methods: Overall, 95 postmenopausal women were included into the study. Back pain was assessed by using Numeric Rating Scale (NRS). Bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck. Postmenopausal women were classified into 3 groups as osteopenia, osteoporosis and normal BMD according to WHO. Quality of life was assessed by using Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). Paraspinal muscle thickness was measured from 4 cm lateral to midline by sonography at the level of the 10th thoracic spine. Results: No significant difference was detected between groups regarding duration of weekly exercises, back pain (NRS) and QUALEFFO values (p > 0.05). In the osteoporosis group, mean muscle thickness was found to be lower in both right and left side when compared to those in osteopenia and normal BMD group (p < 0.01). In addition, mean muscle thickness was found to be lower in both right and left side in osteopenia when compared to normal BMD group (p < 0.01). Conclusion: Our study indicates that reduction in bone mass is related to decrease in muscle mass.
RELATIONSHIP BETWEEN ERECTOR SPINAE MUSCLE THICKNESS AND BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN: AN ULTRASONOGRAPHIC STUDY
(Carbone Editore, 2016) Guler, Hayal; Yildizgoren, Mustafa Turgut; Ustun, Nilgun; Karazincir, Sinem; Balcı, Ali; Ozer, Cahit; Turhanoglu, Ayse Dicle
Introduction: Aging is associated with an increase in the risk of falls and fractures in elderly osteoporotic women in addition to low bone mass and muscle atrophy. We aimed to assess relationship between paraspinal muscle thickness and bone mineral den shy in postmenopausal women. Materials and methods: Overall, 95 postmenopausal women were included into the study. Back pain was assessed by using Numeric Rating Scale (NRS). Bone mineral density (BMD) was measured with dual-energy X-ray absorptiometry (DXA) at the lumbar spine and femoral neck. Postmenopausal women were classified into 3 groups as osteopenia, osteoporosis and normal BMD according to WHO. Quality of life was assessed by using Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). Paraspinal muscle thickness was measured from 4 cm lateral to midline by sonography at the level of the 10th thoracic spine. Results: No significant difference was detected between groups regarding duration of weekly exercises, back pain (NRS) and QUALEFFO values (p>0.05). In the osteoporosis group, mean muscle thickness was found to be lower in both right and left side when compared to those in osteopenia and normal BMD group (p<0.01). In addition, mean muscle thickness was found to be lower in both right and left side in osteopenia when compared to normal BMD group (p<0.01). Conclusion: Our study indicates that reduction in bone mass is related to decrease in muscle mass.

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