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Öğe A comparison of the effectiveness of low-, moderate- and high-dose ultrasound therapy applied in the treatment of myofascial pain syndrome(Springer, 2014) Koca, Irfan; Tutoglu, Ahmet; Boyaci, Ahmet; Ucar, Mehmet; Yagiz, Erman; Isik, Mustafa; Bahsi, AyseObjective. This study aimed to compare and evaluate the effects of ultrasound (US) treatment applied at low-, medium- and high-power-pain threshold (HPPT) doses to trigger points in the treatment of myofascial pain syndrome (MPS). Methods. The study comprised 61 (40 female and 21 male) patients diagnosed with MPS, aged between 18 and 60 years. The patients were randomly allocated to three groups for the US application at different dosages. Group I patients received treatment of medium-dose US (1.5 Watt/cm(2)), Group II received HPPT US, and Group III received low-dose US (0.5 W/cm(2)). The patients were evaluated pre-treatment and 3 weeks after treatment in respect of visual analogue scale (VAS) scores, number of trigger points (NTP), pressure pain threshold (PPT), Range of Tragus-Acromioclavicular joint (RT-AJ) and neck pain disability scores (NPDS). Results. A significant improvement was determined after treatment in all scores except PPT in Group I, in all scores in Group II, and only in the VAS score in Group III. When the groups were compared post-treatment in respect of improvement in NTP, VAS, RT-AJ and NPDS scores, Group II showed significant superiority over Group I, and Group I was determined to have significant superiority over Group III in respect of VAS, RT-AJ and NPDS scores (p < 0.05). Conclusions. In the treatment of MPS, US therapy at HPPT dose can be considered as an alternative therapy method, which is more economical and more effective than low-dose and conventional US therapy.Öğe 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, AyseObjectives: 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.Öğe Peripapillary Retinal Nerve Fiber Layer and Ganglion Cell-Inner Plexiform Layers Thickness in Ankylosing Spondylitis(Informa Healthcare, 2014) Tuzcu, Esra Ayhan; Ustun, Nilgul; Ilhan, Nilufer; Yagiz, Erman; Daglioglu, Mutlu Cihan; Coskun, Mesut; Ilhan, OzgurObjective: To assess the thickness of the retinal nerve fibril layer (RNFL) in cases with ankylosing spondylitis (AS). Materials and methods: The study included 40 AS patients who had no history of acute and/or previous uveitis and 50 healthy controls. After detailed ocular examination, the thickness of the peripapillary RNFL, the macula, and the ganglion cell-inner plexiform layers (GCIPL) were measured by spectral domain optic coherence tomography (SD-OCT). The correlation between the duration of the disease and the thickness of the RNFL, the macula, and the GCIPL were analyzed in the patients who had AS. These patients were then placed into 2 groups according to their BASDAI (Bath Ankylosing Spondylitis Disease Activity Index) score: patients with BASDAI score <4 and those with BASDAI score >= 4. The correlations between the BASDAI score and the mean GCIPL and temporal RNFL thickness were evaluated. Results: No significant difference was detected in the RNFL thickness of the AS patients and that of the controls (p = 0.407). Nor was any significant difference detected in the GCIPL thickness of the AS and the control groups (p = 0.091). In addition, no significant difference was found in the macular thickness when the AS group was compared to the control group (p = 0.139). However, a negative correlation was detected between the duration of the disease and the thickness of the temporal quadrant RNFLs (r = -0.334; p = 0.035). The temporal quadrant RNFL thickness and the mean thickness of the GCPIL were significantly thinner in the AS patients with BASDAI score >= 4 (p = 0.034 and p = 0.025, respectively). Also, the BASDAI score were negatively correlated to the temporal quadrant RNFL and GCIPL thickness (r = -0.332; p = 0.036 and r = -0.348; p = 0.028, respectively). Conclusion: RNFL thickness and GCIPL thickness of ankylosing spondylitis may be affected by the severity and duration of the disease.Öğe 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, AyseObjectives: 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.
