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    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.
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    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.
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    Subclinical Peripheral Neuropathy in Behcet's Disease
    (Deri Zuhrevi Hastaliklar Dernegi, 2009) Okuyucu, Esra Emine; Balci, Didem Didar; Turhanoglu, Ayse; Duman, Taskin; Yilmazer, Serkan; Yenin, Juelide Zehra
    Background and Design: Central nervous system involvement is well known in patients with Behcet's disease but studies evaluating peripheral nervous system is not usual. The aim of this study is to evaluate the frequency and characteristics of subclinical neuropathy in patients with Behcet's disease. Material and Method: Thirty three Behcet's disease patients (23 male, 10 women) with no evident neurological sign and symptom and 33 healthy volunteers were enrolled to the study. To exclude the other causes of peripheral neuropathy, some laboratory investigations were made. Electrophysiological studies of peripheral nerves were performed to all patients and healthy volunteers. The results were assessed according to the American Diabetes Association Diabetic Neuropathy Protocol. Results: Nerve conduction studies were abnormal in 11 of 33 patients (7 men, 4 women; 33.3%). Five patients (15%) had sensorymotor polyneuropathy, 4 (12%) has sural sensory polyneuropathy, 1 (3%) had median and tibial motor neuropathy. Sural nerve were unobtainable in 7 (21%) patients. 2 patients (6%) had prolonged F latency. Control group were normal electrophysiologically and the difference was statistically important (p < 0.0001). There was no correlation between peripheral neuropathy and gender (p=0.696). Conclusion: Despite the detailed neurological examination, subclinical peripheral neuropathy can be seen in patients with Behcet's disease. Electrophysiological studies are useful for the early detection of peripheral neuropathy in these patients. (Turkderm 2009; 43: 61-4)