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Öğe Assessment of neutrophil-lymphocyte and platelet-lymphocyte ratios in ankylosing spondylitis(Turkish League Against Rheumatism, 2016) Boyraz, İsmail; Koç, Bünyamin; Çoğalgil, ŞirzatWe read the article published by Erkol İnal et al.1 with great interest. The authors evaluated the associations between neutrophil-lymphocyte ratio (NLR), mean platelet volume, and plateletlymphocyte ratio (PLR) along with disease activity in ankylosing spondylitis. They found that mean platelet volume is not associated with disease activity, whereas NLR and PLR may reflect disease activity. Although this is a well-written study, it has some methodological drawbacks. The researchers screened complete blood counts, erythrocyte sedimentation rate, C-reactive protein, disease activity, clinical status, and functional status of ankylosing spondylitis patients. They expressed inclusion and exclusion criteria. However, exclusion criteria of this study did not conform with those as noted in other studies.2,3 They did not question the factors such as metabolic syndrome, anemia, secondary hyperparathyroidism, impaired thyroid function, chronic obstructive pulmonary disease, obstructive sleep apnea, connective tissue disease, allergic rhinitis, asthma and smoking history in the patient and control groups. These factors can affect NLR and PLR values. All these elements should be taken into account for determining exclusion criteria. Otherwise, incorrect findings may be obtained when the results are interpreted.Öğe Assessment of relation between neutrophil lympocyte, platelet lympocyte ratios and epicardial fat thickness in patients with ankylosing spondylitis(Medical Association of Zenica-Doboj Canton, 2016) Boyraz, İsmail; Çağlar, Sabri Onur; Erdem, Fatma; Yazıcı, Mehmet; Yazıcı, Selma; Koç, BünyaminAim To investigate whether there is a relation between neutrophil-lymphocyte (N/L) and platelet- lymphocyte (P/L) ratios and epicardial adipose tissue (EAT) thickness in patients with ankylosing spondylitis (AS). Methods Thirty patients diagnosed with ankylosing spondylitis and 25 healthy people (controls) were included in the study. Age, gender, body mass index (BMI), height, hemogram, sedimentation, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, CRP, hepatic and renal function tests, lipid profile of the all patients were recorded. Data related to duration of the disease, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) values of the cases in the patient group were obtained. A cardiologist measured EAT thickness by ECHO in both patient and control groups. Results In the patient group, mean BASDAI and BASFI scores were 2.48±2.21 and 1.5±2.07, respectively. Age, gender, BMI values did not show statistically significant difference between the patient and the control groups. N/L and P/L ratios did not change significantly in the patient group having higher EAT, BASFI values and taking anti-TNF compared to the control group. Conclusion In patients with AS, EAT measurements, which are related to inflammatory response increase, can be used for monitoring of the risk of development of cardiac disease. We could not find the relation between EAT and N/L, P/L ratios in terms of evaluation of inflammatory response. © 2016, Medical Association of Zenica-Doboj Canton. All rights reserved.Öğe Bel ağrısının sık görülmeyen bir nedeni: Radyasyon osteoiti(2015) Bunyamin, Koc; Boyraz, İsmail; Sarman, Hakan61 yaşında bayan hasta polikliniğimize bel ağrısı yakınmasıyla başvurdu. Hastaya yaklaşık 11 ay önce endometrium kanseri nedeniyle total abdominal histerektomi, bilateral salpingooferektomi, omentektomi ve pelvik paraaortik lenf nodu disseksiyonu yapılmış. Cerrahi tedaviyi takiben uygulanan radyoterapiden yaklaşık 4 ay sonra hastanın bel ağrısı yakınmaları başlamış. Hastanın ağrısı daha çok bel kısmındaydı ve bacaklarına vurmuyordu. Yapılan muayenede lomber hareketleri açık, düz bacak kaldırma testi negatifti, siyatik valleks hassasiyeti yoktu ve nörolojik muayenesi normal olarak değerlendirildi. Hastanın tam kan sayımında beyaz küre: 7340/µL, hemoglobin:13,6g/dl, trombosit:287000/µL idi. Sedimantasyon 36, alkalen fosfataz, kalsiyum ve fosfor normal sınırlar içerisinde idi. Olası bir kemik metastazını değerlendirmek amacıyla çekilen tüm vücut kemik sintigrafisi; diz eklemlerinde dejeneratif değişikliklerle uyumlu artmış aktivite tutulumları dışında normal olarak değerlendirildi. Hastanın çekilen lomber vertebral magnetik rezonans görüntülemesinde (MRG) lomber 3-4; 4-5 ve lomber 5 sakral 1. vertebralar arasında bulging mevcuttu. Ayrıca lomber 4. vertebra korpus alt bölümü ile lomber 5. vertebrada ve sakral düzeyde hem T1 hem de T2 kesitlerde hiperintens sinyal intensite değişimi vardı (Resim 1,2). Tarif edilen görünüm radyoloji doktoru tarafından radyoterapiye bağlı olabileceği yönünde yorumlanmıştı. Hasta kliniğimize yatırıldı ve oral analjezik başlandı ve fizyoterapi uygulandı.Öğe Central nervous system involvement mimicking multiple sclerosis in a patient with Sjogren's syndrome(Turkish League Against Rheumatism, 2015) Boyraz, İsmail; Koç, Bünyamin; Yazıcı, SelmaSjogren’s syndrome (SS) is a systemic autoimmune disease that can involve both the peripheral nervous systems and central nervous systems (CNS). It is characterized by a lymphocytic infiltration of all exocrine glands.1 Neurologic symptoms including transverse myelitis, optic neuritis, stroke-like acute symptoms or several neurological disorders like progressive relapsing remitting attacks mimicking multiple sclerosis (MS) may develop in patients with SS. Herein, we reported a patient who had been treated/followed-up previously with the diagnosis of MS and was diagnosed subsequently with SS.Öğe A child patient followed-up with the diagnosis of recurrent complex regional pain syndrome(Galenos Yayincilik, 2016) Boyraz, İsmail; Koç, Bünyamin; Sarman, Hakan; Özkan, Hilal; Tönük, BurakComplex regional pain syndrome is a clinical condition that features a group of typical symptoms, including spontaneous pain, edema, tenderness, swelling of an extremity along with varying degrees of sweating, warmth and/or coolness, flushing, discoloration, and shiny skin. A 12-year-old female patient referred to the department of pediatrics with complaints of swelling, pain, reddening, and movement difficulty in her right hand. Her attacks repeated 3 times. Cervical stellate ganglion blockage relieved symptoms immediately at the last attack.Öğe Clonus: Definition, mechanism, treatment(Medical Association of Zenica-Doboj Canton, 2015) Boyraz, İsmail; Uysal, Hilmi; Koç, Bunyamin; Sarman, HakanClonus is involuntary and rhythmic muscle contractions caused by a permanent lesion in descending motor neurons. Clonus may be found at the ankle, patella, triceps surae, wrist, jaw, biceps brachii. In general, clonus may occur in any muscle with a frequency of 5-8 Hz and the average period of oscillations of the ankle clonus is approximately 160–200 ms. Plantar flexion (PF) comprises 45% of the period, dorsifleksion (DF) comprises 55% of the period. The first beat is always longer, with the time shortening in continuing beats and becoming stable in the 4th or 5th period. The exact mechanism of clonus remains unclear. Two different hypotheses have been asserted regarding the development of clonus. The most widely accepted explanation is that hyperactive stretch reflexes in clonus are caused by self-excitation. Another alternative explanation for clonus is central generator activity that arises as a consequence of appropriate peripheral events and produces rhythmic stimulation of the lower motor neurons. The durations of clonus burst were found longer than the durations of Soleus medium-latency reflex (MLR). There is a similarity in their nature, although the speed and cause of the stretch of triceps surae differ in the MLR and the clonus, and there is a sufficient period of time for group II afferents and for other spinal mechanisms to be involved in the clonus, together with Ia afferents. Clonus can be treated by using baclofen, applying cold, botox or phenol injections. © 2015 Medical Association of Zenica-Doboj Canton. All rights reserved.Öğe Comment on "the effect of a community-based, primary health care exercise program on inflammatory biomarkers and hormone levels''(Hindawi Ltd, 2015) Koç, Bünyamin; Sarman, Hakan; Boyraz, İsmailWe read with great interest the recent paper by C. B. Papini et al. in which the authors examined “impact of a communitybased exercise program in primary care on inflammatory biomarkers and hormone levels” in the 1-year quasiexperimental study [1]. The authors very clearly discussed the relation between exercise and inflammation. They concluded that community-based exercise program can result in a decrease or maintenance of inflammatory biomarkers after 1 year, and it has the potential to be a viable public health approach for chronic disease prevention.This study displayed that public health exercise intervention delivered in lowincome communities has the potential to use a beneficial effect and improve or maintain inflammatory biomarkers profiles, supporting the prevention of chronic diseases. The authors did not discuss exclusion criteria in this paper. However it is well established that any type of systemic inflammation, autoimmune disorders, and malignant or chronic illnesses may affect inflammatory biomarkers and hormone levels [2]. Also obesity is related to elevated serum levels of some inflammatory markers, such as leptin, TNF- ��, and CRP [3, 4]. Because of high prevalence of these conditions, we believe that these situations may have a role in the results of the paper by C. B. Papini et al.Öğe Comparison of high-intensity laser therapy and ultrasound treatment in the patients with lumbar discopathy(Hindawi Ltd, 2015) Boyraz, İsmail; Yıldız, Ahmet; Koç, Bünyamin; Sarman, HakanThe aim of the present study was to evaluate the efficiency of high intensity laser and ultrasound therapy in patients who were diagnosed with lumbar disc herniation and who were capable of performing physical exercises. 65 patients diagnosed with lumbar disc were included in the study. The patients were randomly divided into three groups: Group 1 received 10 sessions of high intensity laser to the lumbar region, Group 2 received 10 sessions of ultrasound, and Group 3 received medical therapy for 10 days and isometric lumbar exercises. The efficacy of the treatment modalities was compared with the assessment of the patients before the therapy at the end of the therapy, and in third month after the therapy. Comparing the changes between groups, statically significant difference was observed in MH(mental health) parameter before treatment between Groups 1 and 2 and in MH parameter and VAS score in third month of the therapy between Groups 2 and 3. However, the evaluation of the patients after ten days of treatment did not show significant differences between the groups compared to baseline values. We found that HILT, ultrasound, and exercise were efficient therapies for lumbar discopathy but HILT and ultrasound had longer effect on some parameters.Öğe The Demographic Characteristics of Patients Admitted to the Emergency due to Low Back Pain(2015) Boyraz, İsmail; Duran, Arif; Koç, Bünyamin; Erkuran, Mansur Kürşad; Sarman, Hakan; Yazıcı, SelmaAmaç: 2007-2015 yılları arasında bel şikayetiyle acile başvuran hastaların demografik özelliklerini incelemek istedik Gereç-Yöntem: Abant İzzet Baysal Üniversitesi Tıp Fakültesi Hastanesi ve Kamu Hastaneler birliğine bağlı acil servislere 2007- 2015 yılları arasında bel şikayetiyle acile başvuran hastalar retrospektif olarak kayıtlardan incelendi. Hastaların demografik özellikleri ve hasta bilgileri kayıtlardan elde edildi. Acile başvurduğunda ilk teşhisi bel olan hastalar çalışmaya dahil edildi. Travma veya kaza geçiren, akut kırık teşhisi konulmuş olan hastalar incelemeye dahil edilmedi. Hastaların yaş, cinsiyet, başvuru zamanının hangi saat, gün, ay, yıl ve mevsimde olduğu, acilde ne kadar kaldığı ve başka servise sevk edilmişse hangi bölüme sevk edildiği ve orda kaç gün yattığı incelendi. Cerrahi servislerden birine sevk edilmişse cerrahi yapılıp yapılmadığı kaydedildi. Bulgular: Bel ağrısı teşhisiyle acile başvurmuş ve tedavi almış toplam hasta sayısı 43233 idi. Bunlardan 22372 hasta yaklaşık % 51.7’si erkek, 20861 hasta yaklaşık %48.3’ü kadındı.11 hasta Genel cerrahiye nakledilmiş, 14 hasta Ortopedi ve Travmatoloji servisine, 3 hasta Kadın Hastalıkları ve Doğum servisine, 1 hasta üroloji servisine, 1 hasta Göğüs Cerrahisi servisine, 699 hasta Beyin Cerrahi servisine yatırılmış. 5 hasta Algoloji, 3 hasta Çocuk Hastalıkları, 20 hasta Enfeksiyon Hastalıkları, 89 hasta Fizik Tedavi ve Rehabilitasyon, 9 hasta Dahiliye, 5 hasta Kardiyoloji, 11 hasta Nöroloji, 1 hasta Yoğun Bakım servisine yatırılmıştır. Sonuç: Hastanın anemnezi ve fizik muayenesi çok iyi yapılırsa gereksiz tetkik ve tedavilerin önüne geçilmiş olur. Yapılacak geniş çaplı çalışmalar sayesinde acil hekimlerinin karşılaşabilecekleri bel ağrılı hastadaki teşhis ve tedavi stratejisinin belirlenmesi konusunda izleyecekleri bir paradigma oluşturulabilir.Öğe Demographic characteristics of the patients referred to physical therapy outpatient clinic(Modestum Ltd, 2016) Boyraz, İsmail; Koç, Bünyamin; Yazıcı, SelmaObjective: Physical medicine and rehabilitation is a medical science which has very wide scope, although pain is the main symptom in patients admitted physical therapy polyclinic. The aim of the present study was to examine the demographic features of the patients who were admitted to the physical medicine outpatient clinic in 2010-2014 years. Method: The medical records of 46729 patients, who were admitted to the outpatient clinics affiliated with Abant Izzet Baysal University Faculty of Medicine and Association of Public Hospitals, were retrospectively reviewed. Of these patients, 29721 (63.6%) were females and 17,008 (36.4%) were males. The mean age of the patients was 51.7 years. The mean age was 53.3 years in female patients and 48.9 years in male patients. Results: Of the patients, 10111 had lumbar problems, 7816 in knee, 5612 in neck, and 3652 in shoulder, respectively. The present study attempted to present in detail the characteristics of the patients who were admitted to the outpatient clinics. Conclusion: Such studies may guide hospitals in taking necessary precautions depending on the volume of patients who present to the outpatient clinics for follow-up and treatment.Öğe Diyabetes mellitüs ve periferik organ tutulumu: Güncel tedavi seçenekleri(2014) Işık, Cengiz; Sarman, Hakan; Şahin, Abdullah Alper; Kargi, Ertugrul; Sarman, Züleyha; Erkuran, Mansur Kürşad; Boyraz, İsmailDiyabetes mellitüs bireylerin ve toplumların uzun süreli yaşam şekline etki eden kronik, multisistemik ve tedavi seçenekleri çeşitlilik gösteren bir hastalıktır. Hastalığın kendisinin vücutta yaptığı değişimler kadar uzun dönemde periferik organlarda oluşturduğu hasarlar sonucu önemli morbidite ve mortalite nedenidir. Bu derlemede Diyabetes mellitüs kendisinin direkt yaptığı dahili hastalıktan ziyade periferik organ tutulumu sonucu gelişen komplikasyonları ve tedavi seçeneklerini literatür eşliğinde değerlendirmeyi amaçladık.Öğe Effect of robotic training on walking and balance in patient with Hereditary Spastic Paraplegia(Medical Investigations Soc, 2016) Boyraz, İsmail; Koç, Bünyamin; Sarman, Hakan; Özdemir, MesutOur patient was 22 years old and was being followed with pure Hereditary Spastic Paraplegia. He was provided with robot assisted-gait training combined with physiotherapy. Robot-assisted gait training lasted 40 minutes per a day and 20 sessions training. enforced about 7 weeks and three times in a week. Strenghten, stretching and balance exercise were applied as physiotherapy every day. He was evealuated in terms of functional ambulation category, Medical Research Council (MRC) Scale for muscle strength, Modified Ashworth Scale (MAS), 6-minute walking test, 10-meter walking test, timed up and go, Berg Balance Scale before and after treatment. After the treatments, the patient could walk more confidently and speedy. Robotic training can contribute to physiotherapy as plus to improve patient walking and balanceÖğe Electrophysiological and clinical evaluation of the effects of transcutaneous electrical nerve stimulation on the spasticity in the hemiplegic stroke patients(Soc Physical Therapy Science, 2015) Karakoyun, Ahmet; Boyraz, İsmail; Gündüz, Ramazan; Karamercan, Ayşe; Özgirgin, Neşe[Purpose] To investigate whether transcutaneous electrical nerve stimulation (TENS) mitigates the spasticity of hemiplegic stroke patients, as assessed by electrophysiological variables, and the effects, if any, on the clinical appearance of spasticity. [Subjects and Methods] Twenty-seven subjects who had acute hemiplegia and 24 healthy people as the control group, were enrolled in this study. Some of the acute cerebrovascular disease patients could walk. Subjects who did not have spasticity, who were taking antispasticity medicine, or had a previous episode of cerebrovascular disease were excluded. The walking speed of the patients was recorded before and after TENS. EMG examinations were performed on the healthy controls and in the affected side of the patients. A 30-minute single session of TENS was applied to lower extremity. At 10 minutes after TENS, the EMG examinations were repeated. [Results] A statistically significant decrease in the spasticity variables, and increased walking speed were found post-TENS. The lower M amplitude and higher H reflex amplitude, H/M maximum amplitude ratio, H slope, and H slope/M slope ratio on the spastic side were found to be statistically significant. [Conclusion] TENS application for hemiplegic patients with spastic lower extremities due to cerebrovascular disease resulted in marked improvement in clinical scales of spasticity and significant changes in the electrophysiological variables.Öğe Epicardial fat thickness in patients with rheumatoid arthritis(Makerere Univ, Fac Med, 2015) Erdem, Fatma; Koç, Bünyamin; Sarıkaya, Savaş; Uçar, Mehmet; Yazıcı, Selma; Boyraz, İsmail; Çağlar, Sabri; Özyalvaçlı, Gülzade; Dönmez, İbrahim; Yazıcı, MehmetBackground: Epidemiologic data indicates that rheumatoid arthritis is an independent risk factor for cardiovascular disease. Epicardial adipose tissue is a novel cardio-metabolic risk factor. Our aim was to evaluate epicardial fat thickness (EFT) using echocardiography in patients with rheumatoid arthritis compared to healthy control subjects. Secondly, we investigated relationship between epicardial fat thickness and clinical and echocardiographic parameters in patients with rheumatoid arthritis. Method: The study population included 76 consecutive patients with rheumatoid arthritis (64 female; mean age, 53 +/- 11 years, median disease duration, 7.8 years) and 50 healthy subjects as controls (39 female; mean age, 52 +/- 6 years). All patients underwent echocardiography to assess left ventricular diastolic dysfunction, left ventricular hypertrophy and EFT. All values were compared between groups. Results: EFT was higher in rheumatoid arthritis patients than in healthy controls (0.66 +/- 0.20 vs. 0.54 +/- 0.18; p=0.003). Thickness of Intra Ventricular Septum (IVS) (1.1 +/- 0.06 and 9.8 +/- 0.08; p=0.001) and posterior wall (PW) (0.98 +/- 0.05 and 0.93 +/- 0.08; p=0.015) was higher in patients with rheumatoid arthritis compared to healthy controls. Early diastolic myocardiac peak velocity or late diastolic mitral peak velocity (E/A) ratio was lower in rheumatoid arthritis patients compared to healthy patients (1.1 +/- 0.8 and 1.24 +/- 0.1 p=0.001) as well as, E/e' was higher in Rheumatoid arthritis (RA) patients than healthy patients. (E/e': 8.7 +/- 1.6 and 8.0 +/- 1.4 p=0.020). In patients with rheumatoid arthritis, EFT was positively correlated with hypertension and duration of disease and E/e' (r: 0.10, p: 0.010, r: 0.306, p: 0.004 and r: 0.465 p: 0.007 respectively) and EFT was negatively correlated with E/A (r: -. 262 p: 0.022) Conclusion: To our knowledge, this is the first report about epicardial adipose tissue in rheumatoid arthritis patients. Epicardial fat thickness as an indicator of cardiovascular involvement was higher in rheumatoid arthritis patients.Öğe Erişkin radius distal uç kırıklarında konservatif tedavi sonuçlarının, karşı taraf el bileği ile karşılaştırılması: Radyolojik ve fonksiyonel değerlendirme(2014) Uslu, Mustafa; Arıcan, Mehmet; Işık, Cengiz; Sarman, Hakan; Boyraz, İsmailAmaç: Erişkin hastalarda kapalı redüksiyon ve uzun kol alçı ile tedavi edilen distal radius uç kırıklarının radyolojik ve fonksiyonel sonuçları karşı taraf el bileği ile karşılaştırılarak değerlendirildi.Yöntemler: Ocak 2010-Aralık 2010 tarihleri arasında 77 hastaya distal radius uç kırığı için konservatif tedavi uygulandı. Kırıklar prospektif olarak incelendi ve AO ile Frykman sınıflama sistemi kullanıldı. Radyolojik ve anatomik sonuçlar Stewart skorlama kriteri ile değerlendirildi. Fonksiyonel sonuçlar kol, omuz ve el sakatlık sorgulaması (Q-DASH) ve Stewart II skorlama kriterleri değerlendirildi. Hastaların ortalama takip süresi 12 aydı.Bulgular: 40 hastanın sağ el bileğinde, 37 hastanın sol el bileğinde kırık mevcuttu. Frykman sınıflamasına göre 46 olgu tip I-II kırık, AO sınıflamasına göre 59 olguda 23,A2,1 ve 23,A2,2 kırık tespit edildi. Stewart radyolojik ve anatomik skorlama kriterine göre 77 hastanın toplam 57'sinde mükemmel, 17'sinde iyi, 3'ünde orta sonuç elde edildi. Stewart II'ye göre fonksiyonel skorlama kriterler sonuçları değerlendirildiğinde, 57 hastada mükemmel, 8 hastada iyi, 12 hastada orta sonuç alındı. Q-DASH skoru ortalama puanı 6,37 olarak bulundu. Komplikasyon oranlarımız %12,98 idi. İki hastada median sinirde hafif derecede tuzaklanma, dört hastada ulna stiloidinde kaynamama, bir hastada distal radioulnar eklemde hassasiyet, üç hastada distal radioulnar eklemde hassasiyet ve median sinirde hafif derecede tuzaklanma idi.Sonuç: Distal radius kırıkları tedavisinde kapalı redüksiyon ve alçılı tespit halen etkin ve son derece ucuz bir tedavi yöntemi olarak görülmektedirÖğe Erişkin still hastalığı teşhisiyle izlenen hastada makrofaj aktivasyon sendromu gelişimi(2015) Boyraz, İsmail; Yazıcı, Selma; Koç, Bünyamin; Yıldız, Ahmet; Güven, UmutStill hastalığı sistemik başlangıçlı juvenil idiopatik artritin (SOJİA) analoğu olan sistemik enflamatuar bir hastalıktır. Makrofaj aktivasyon sendromu (MAS) SOJİA'da görülen mortalite ve morbiditenin önemli nedenlerinden biridir. 2 yıldır Still hastalığı teşhisi ile izlenen 20 yaşındaki bayan hasta methotrexate 15 mg/hafta, Plaquenil 200 mg, folbiol tb almaktaydı. Hasta alt ekstremitede yaygın cilt kızarıkları ve artralji şikayetleriyle polikliniğimize başvurdu. Tetkiklerinde akut faz reaktanlarında yükselme vardı ve hastada Still aktivasyonu düşünülerek Salazopyrin tb eklendi. 1 hafta sonra 3-4 gündür devam eden boğaz ağrısı ve yutma güçlüğü şikayetiyle tekrar kliniğimize başvurdu. Hastanın takibinde genel durumunda ve laboratuvar değerlerinde bozulma görüldü. Hastanın sonraki muayenesinde yaygın lenfadenopati, splenomegali saptandı, oral alımı kesilmişti. Bulantı, kusma ve ateşi devam ediyordu. Hastada Makrofaj Aktivasyon Sendromu düşünülerek hematoloji konsültasyonu istendi ve yatışından 1 hafta sonra teşhis amaçlı yapılan kemik iliği biyopsisi ile Hemofagositik sendrom teşhisi konuldu. Hastaya pulse steroid (1 gr/gün), İVİG ve Siklosporin 100 mg 2*1 tedavisi düzenlendiÖğe Evaluation of wrist flexor - extensor muscle strength in patients with Carpal Tunnel Syndrome(Wiley-Blackwell, 2015) Yılmaz, Hamit; Boyraz, İsmail; Benek, Bedri Selim; Şakar, Hakan; Bayram, Şaban; Gümüştekin, KenanÖğe Evaluation of atrial conduction times, epicardial fat thickness and carotid intima-media thickness in patients with ankylosing spondylitis(Turkish League Against Rheumatism, 2016) Çağlar, Sabri Onur; Boyraz, İsmail; Erdem, Fatma; Yazıcı, Selma; Çağlar, HilalObjectives: This study aims to determine the relationship between atrial electromechanical delay (EMD), carotid intima-media thickness (CIMT), and epicardial fat thickness (EFT) in ankylosing spondylitis (AS), which has a complicated inflammatory nature. Patients and methods: The study population included 42 consecutive patients with AS (28 males, 14 females; mean age 39.3 +/- 8.5 years; range 22 to 60 years) and 40 healthy subjects as controls (24 males, 16 females; mean age 37.2 +/- 8.7 years; range 22 to 60 years) (p>0.05). All patients underwent a standard tissue Doppler echocardiography to assess the left ventricular diastolic dysfunction, atrial EMD, CIMT, and EFT. All values were compared between the groups. Results: Interatrial (29.5 +/- 5.8 ms vs. 17.9 +/- 5.3 ms) left and right intraatrial EMD (18.2 +/- 4.6 ms and 11.7 +/- 3.5 ms vs. 11.9 +/- 3.2 ms and 7.1 +/- 3.2 ms, respectively) intervals were longer in AS patients than in healthy controls (all p<0.001). Left and right CIMT (0.50 +/- 0.11 mm and 0.44 +/- 0.06 mm vs. 0.51 +/- 0.11 mm and 0.43 +/- 0.04 mm, respectively) and EFT (0.73 +/- 0.15 cm and 0.63 +/- 0.07 cm) values were higher in AS patients than in healthy controls (all p<0.01). Conclusion: To our best knowledge, this is the first report evaluating the atrial EMD, CIMT, and EFT values together in AS patients. As indicators of cardiovascular involvement, all parameters were higher in AS patients.Öğe Gonartozun Patofizyolojisi ve Klinik Değerlendirilmesi(2015) Koç, Bünyamin; Boyraz, İsmail; Sarman, HakanOsteoartrit (OA) tüm eklemi tutan kıkırdak dejenerasyonu, sinovit, subkondral kemik oluşumu, kapsül hipertrofisi ve yumuşak doku rüptürlerinin yanında enflamatuar mediatörlerin de rol oynadığı kompleks bir süreçtir. Hastaların ekleminde genellikle dizilim ve mekanik dengesizlik gelişir. Tüm bu sürece aralıklı sinovit ve lokal inflamasyonda eşlik eder. OA'lı hastalarda kemiğin yeniden yapımı sonucu oluşan periost inflamasyonu ile çıplak kemik oluşur. Radyografik olarak OA hastalarında ağrı kaynağı tam olarak açıklanamamıştır. Yapılan araştırmalarda radyografik bulgularla ağrı arasında doğrudan bir korelasyon bulunamamıştır. OA tedavisinin primer amacı ağrıyı azaltmaktır. İlk yapılacak öneriler, hasta bilgilendirilmesi ve eğitimi, obez ise kilo verilmesi ve egzersizlerdir. Medikal tedavi olarak parasetamol ve nonsteroid anti-İnflamatuar İlaçlar (NSAİİ) en çok tavsiye edilen ilaçlardır. Koruyucu tedaviler yeterli gelmediğinde cerrahi tedavi düşünülebilir ama sonuçlar her zaman yüz güldürücü değildir.Öğe Is RDW a predictive parameter for cubital tunnel syndrome patients requiring surgery(Atha Comunicacao & Editora, 2016) Sarman, Hakan; Işık, Cengiz; Boz, Mehmet; Boyraz, İsmail; Koç, Bünyamin; Türkoğlu, Şule AydınObjective: The aim of this study was to investigate whether haemogram parameters are predictive factors for both the severity of the disease and a decision in favor of surgical treatment in patients with an established diagnosis of cubital tunnel syndrome (CuTS). Methods: The medical files of patients with a diagnosis of CuTS who were followed-up conservatively (n=92) or surgically treated (n=92) were retrospectively screened and the haemogram parameters were recorded. Results: The receiver operating characteristic (ROC) curve analysis revealed an area of 0.665 under the curve, with 76.3% sensitivity and 84.8% specificity at the cut-off of a red cell distribution width (RDW) level grater than 15.45%. RDW levels higher than 15.5%, electromyography (EMG) severity, and a clinical score higher than three were found to be independently associated with surgery. Conclusion: An elevated RDW value was related to the severity of the electromyogram. RDW may, therefore, be a useful independent predictor for the decision to surgical treatment of CuTS.
