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Öğe Central Nervous System Involvement Mimicking Multiple Sclerosis in a Patient With Sjogren's Syndrome(2015) Boyraz, Ismail; Koç, Bünyamin; Yazici, Selma-Öğe The effect of breast-feeding duration on bone mineral density in postmenopausal Turkish women: a population-based study(Termedia Publishing House Ltd, 2011) Yazici, Selma; Korkmaz, Ugur; Erkan, Melih; Korkmaz, Nurdan; Baki, Ali Erdem; Alcelik, Aytekin; Onder, ElifIntroduction: In the present study, we investigated the effects of breast-feeding time on bone mineral density (BMD) later in life. Material and methods: The current study was based on a retrospective analysis of 586 postmenopausal women with a mean age of 60.8 years, who were screened for osteoporosis by dual energy X-ray absorptiometry (DXA). They were classified into 4 groups with respect to the duration of their breast-feeding as never (group 1), 1-24 months (group 2), 25-60 months (group 3), or > 60 months (group 4). Bone mineral density results for the femur neck and lumbar spine were classified into 3 groups according to WHO criteria as normal (T score > -1.0 SD), osteopenia (T score -1.0 to -2.5 SD), and osteoporosis (T score < -2.5 SD). Patients with osteopenia or osteoporosis (T score < -1.0 SD) were considered as having low bone mass (LBM). Results: We found a correlation between duration of lactation and femur BMD or spine BMD in the study population (r = 0.116, p < 0.005; r = -0.151, p = 0.001, respectively). Significant differences were found between femur BMD and spine BMD of groups in one-way ANOVA analysis (p = 0.025, p = 0.005, respectively). Additionally, when compared with the other three groups, group 4 was older and had longer duration of menopause (p < 0.01). In logistic regression analysis, age and body mass index were found as independent risk factors of LBM [odds ratio: 1.084 (95% CI 1.031-1.141); odds ratio: 0.896 (95% CI 0.859-0.935)], while duration of lactation was not found as an independent predictor of LBM. Conclusions: In this study, we have found that changes of bone metabolism during lactation had no effect on postmenopausal BMD measured by DXA. Consequently, it can be suggested that long breast-feeding duration is not a risk factor for low bone mass later in life.Öğe Evaluation of Atrial Conduction Times, Epicardial Fat Thickness and Carotid Intima-Media Thickness in Patients With Ankylosing Spondylitis(2016) Çağlar, Sabri Onur; Boyraz, Ismail; Erdem, Fatma; Yazici, Selma; Caglar, Hilal; Koç, Bünyamin; Çağlar, EmrahObjectives: 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 Fibromiyalji sendromunda kardiyovasküler sistemin değerlendirilmesi: doku Doppler ekokardiyografik inceleme(2010) Yazici, Selma; Yazici, Mehmet; Albayrak, Sinan; Makarç, Sevim; Kolbas, Melek; Erbilen, Enver; Akdemir, RamazanAmaç: Biz Fibromiyalji (FM) hastalarında kardiyak yapı ve fonksiyonların hem geleneksel hem de yeni ve faydalı bir metot olan doku Doppler ekokardiyografik (DDE) yöntemle incelemeyi amaçladık. Ayrıca, hastalığın patogenezinde olası mekanizmalardan biri olarak gösterilen otonom fonksiyon bozukluğunu elektrokardiyografik olarak QT parametrelerini (QT maksimum, QT minimum ve QT dispersiyonu) ölçerek değerlendirdik. Yöntem: Çalışma aynı kliniğe başvuran 42 hasta (ortalama yaş 41, 38 kadın ) ve kontrol grubu olarak alınan tamamen sağlıklı 38 kişi üzerinde yapıldı. Bireylerin her birine tam bir fizik muayene, elektrokardiyografik (50 mm/s hızla kaydedilen) ve ekokardiyografik (hem geleneksel, hem de DDE) ile değerlendirme yapıldı. Bulgular: Elektrokardiografik kayıtların analizinde QT dispersiyonunda hafif fakat istatistiksel olarak anlamlı olmayan bir artış saptandı. Geleneksel ekokardiyografik parametreler açısından hasta grubu ile kontrol grubu benzerdi. Bununla birlikte bu çalışmanın önemli bir bulgusu hasta grubunda DDE yöntemi ile saptanan gevşeme bozukluğu idi. Em dalga hızı ve Em/Am oranları FM hastalarında kontrollere kıyasla anlamlı düzeyde düşüktü (sırasıyla, p < 0.005, p < 0.01). Sm ve Am dalga hızları ise her iki grupta da benzerdi. Sonuç: Bu çalışmada hasta grubunda DDE yöntemi ile saptanan sol ventrikülün gevşeme bozukluğu FM’de görülen yorgunluk ve nefes darlığı gibi bazı semptomları kısmen açıklayabilir. Ayrıca tam bir kardiyak değerlendirme yapılması ile fibromiyaljinin patogenezindeki otonomik disfonksiyon teorisini destekleyecek bulgular elde edilebilir.Öğe Metabolic Syndrome in Patients With Ankylosing Spondylitis(Elmer Press Inc, 2011) Batmaz, Ibrahim; Karakoc, Mehmet; Sariyildiz, Mustafa Akif; Yazici, Selma; Tahtasiz, Mehmet; Atilgan, Zuhal; Cevik, RemziBackground: The objective of this study is to investigate the presence of metabolic syndrome (MS) in patients with ankylosing spondylitis (AS) and to evaluate its relationship with the clinical parameters. Methods: Fifty patients who presented to the Dicle University School of Medicine, Physical Therapy and Rehabilitation Outpatient Clinic and were diagnosed with AS according to the 1984 New York criteria were enrolled in this study. The control group consisted of 44 healthy control subjects. Assessment of the MS was made according to the diagnostic criteria specified in the National Cholesterol Education Program Adult Treatment Panel III Report (NCEP ATP III). Functional status and disease activity were evaluated using the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for AS. Results: MS was observed in 6 out of the 50 AS patients (12%) and in 2 out of the 44 controls (4.5%) (P > 0.05). However, the HDL cholesterol level (P = 0.006) was found as significantly lower in AS patients than the controls. No statistically significant differences were observed in the disease duration and functional and clinical activity indices between the AS patients with and without MS. Conclusions: Although the frequency of MS was observed to be higher in patients with AS than the controls in this study, the differences were statistically insignificant between the two groups.Öğe Thyroid functions in rheumatismal diseases(2005) Yazici, Selma; Ya?li, Melek; Atao?lu, SafinazThyroid hormones are one of the most effective hormones on musculoskeletal system. It is well known that thyroid gland dysfunctions cause a variety of rheumatologic signs and symptoms including muscle weakness, fatigue and osteopenia. We aimed to evaluate the effects of thyroid function diseases on the occurrance of rheumatological diseases and coincidency of these two entities. 873 patients with rheumatological disorders were involved to the study. 1.01% of patients with osteoarthritis had subclinical hypothyroidism, 3.03% had subclinical hyperthyroidism, 1.77% had clinical hyperthyroidism. 2.5% of patients with osteoporosis had subclinical hypothyroidism, 11.95% had subclinical hyperthyroidism, 2.17% had clinical hyperthyroidism. 0.8% of patients with soft tissue rheumatological diseases had subclinical hypothyroidism, 5.3% had subclinical hyperthyroidism and 3.84% of patients with discus diseases had subclinical hyperthyroidism. 2.08% of patients with fibromyalgia had subclinical hypothyroidism, 2.08% of patients with fibromyalgia had subclinical hyperthyroidism. 11.76% of patients with rheumatoid arthritis, 3.3% of patients with ancylosing spondylitis, 7.6% of patients with carpal-tunnel syndrome had subclinical hyperthyroidism. Two patients with systemic sclerosis and overlap syndrome had normal thyroid functions. c As a result, a variety of rheumatological and thyroid pathologies may overlap and thyroid diseases should always be in mind when evaluating rheumatological diseases. With proper combined treatment we can get better results.
