IntroductionOsteoporosis is a disease that is characterized by low bone mass, deterioration of bone tissue, and disruption of bone microarchitecture: it can lead to compromised bone strength and an increase in the risk of fractures (1).Osteoporosis is the most common bone disease in humans, representing a major public health problem. It is more common in Caucasians, women, and older people. Osteoporosis is a risk factor for fracture just as hypertension is for stroke. Osteoporosis affects an enormous number of people, of both sexes and all races, and its prevalence will increase as the population ages. It is a silent disease until fractures occur, which causes important secondary health problems and even death ( Figure 1) (2).It was estimated that the number of patients worldwide with osteoporotic hip fractures is more than 200 million (3). It was reported that in both Europe and the United States, 30% women are osteoporotic, and it was estimated that 40% post-menopausal women and 30% men will experience an osteoporotic fracture in the rest of their lives (4-6).Osteoporosis is also an important health issue in Turkey, because the number of older people is increasing. The incidence rate for hip fracture increases exponentially with age in all countries as well as in Turkey, which is evident in the FRACTURK study (7). It was estimated that around the age of 50 years, the probability of having a hip fracture in the remaining lifetime was 3.5% in men and 14.6% in women (7).Bone tissue is continuously lost by resorption and rebuilt by formation; bone loss occurs if the resorption rate is more than the formation rate. The bone mass is modeled (grows and takes its final shape) from birth to adulthood: bone mass reaches its peak (referred to as peak bone mass (PBM)) at puberty; subsequently, the loss of bone mass starts. PBM is largely determined by genetic factors, health during growth, nutrition, endocrine status, gender, and physical activity. Bone remodeling, which involves the removal of older bone to replace with new bone, is used to repair microfractures and prevent them from becoming macrofractures, thereby assisting in maintaining a healthy skeleton. Menopause and advancing age cause an imbalance between resorption and formation rates (resorption becomes higher than absorption), thereby increasing the risk of fracture. Certain factors that increase resorption more than formation also induce bone loss, revealing the microarchitecture. Individual trabecular plates of bone are lost, leaving an architecturally weakened structure with significantly reduced mass; this leads to an increased risk of fracture that is aggravated by other aging-associated declines in functioning. Increasing evidence suggests that rapid Osteoporosis -related to various factors including menopause and aging-is the most common chronic metabolic bone disease, which is characterized by increased bone fragility. Although it is seen in all age groups, gender, and races, it is more common in Caucasians (white race), older people, and wom...

Background The 30-day readmission rate is an important indicator of patient safety and hospital’s quality performance. In this study, we aimed to find out the 30-day readmission rate of mild and moderate severity COVID-19 patients discharged from a tertiary care university hospital and to demonstrate the possible factors associated with readmission. Methods This is an observational, single-center study. Epidemiological and clinical data of patients who were hospitalized with a diagnosis of COVID-19 were retrieved from a research database where patient information was recorded prospectively. Readmission data was sought from the hospital information management system and National Health Record System to detect if the patients were readmitted to any hospital within 30 days of discharge. Adult patients (≥18 years-old) hospitalized in COVID-19 wards with a diagnosis of mild or moderate COVID-19 between March 20, 2020 (when the first case was admitted to our hospital), and April 26, 2020 were included. Results From March 26 to May 1, there were 154 mild or moderate severity (non-critical) COVID-19 patients discharged from COVID-19 wards, of which 11 (7.1%) were readmitted The median time of readmission was 8.1 days (IQR=5.2). Two patients (18.1%) were categorized to have mild disease and the remaining 9 (81.9%) as moderate disease. Two patients who were over 65 years of age and had metastatic cancers and hypertension developed sepsis and died in the hospital during the readmission episode. Malignancy (18.7% vs 2.1%, P = 0.04) and hypertension (45.5% vs 14%, P = 0.02) were more common in those who were readmitted. Conclusions This is one of the first studies to report on 30-day readmission rate of COVID-19 in the literature. More comprehensive studies are needed to reveal the causes and predictors of COVID-19 readmissions.

Diabetic patients may suffer from a wide range of musculoskeletal disorders that can cause pain and some dysfunctions in the patient and affect the treatment negatively or reduce the quality of life by causing problems in the implementation of exercise programs, which are very important in the treatment of patients with Diabetes Mellitus. Although most of these problems are also seen in non-diabetics, they are more frequently observed but are not specific to diabetics. Their physiopathology is not fully understood; there is some evidence suggesting that macro- and microvascular complications of diabetes are responsible. A diagnosis of musculoskeletal dysfunctions in diabetic patients is made by clinical findings, and there is currently no specific treatment. If the treatment of problems requires corticosteroid use, diabetes can be hard to manage. In this review, we summarized the general features, diagnosis, and treatment modalities of frequent and important musculoskeletal disorders in diabetic patients.

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BackgroundImmunization is one of the most effective public health measures to prevent disease, but vaccination rates in adult populations still remain below the targets. Patient and physician attitudes about vaccination are important for adult vaccination. In this study, we aimed to determine patient attitudes and perceptions about vaccination and the vaccination coverage rates of adult patients in a university hospital in Turkey.Material/MethodsA survey was conducted between October 2014 and May 2015 at the Internal Medicine Outpatient Clinics of a university hospital. Adult patients were asked to fill out a questionnaire on their perceptions and attitudes about vaccination and their vaccination status.ResultsWe interviewed 512 patients ages 19–64 years. Eighty percent of the study population thought that adults should be vaccinated, while only 36.1% of the patients stated that vaccination was ever recommended to them in their adult life. Forty-eight percent of the patients stated that they were vaccinated at least once in their adulthood. The most commonly received vaccine was tetanus vaccine in general, while influenza vaccine was the leading vaccine among patients with chronic medical conditions. While 71.4% of the patients to whom vaccination was recommended received the vaccine, 34.9% of the patients received a vaccine without any recommendation.ConclusionsAlthough the vaccine coverage rates among adults in this survey were low, the perceptions of patients about adult vaccination were mainly positive and of many of them positively reacted when their physician recommended a vaccine.