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BackgroundCharlson Comorbidity Index (CCI) is the common and valid method to predict mortality by classifying comorbidities such as cardiovascular, metabolic, renal, hepatic, pulmonary diseases, and malignancy. Novel risk factors are not included in the Charlson Comorbidity Index, such as thyroid hormone index (FT3/FT4 ratio) and serum albumin levels. In the present study, we aimed to assess whether the thyroid hormone index and albumin are useful clinical parameters in short and long-term mortality.MethodsIn the retrospective cohort study with a 5 year follow up, the data of 1292 patients who were hospitalized between January 1st-June 30th of 2014 were examined. Three months mortality as short term and 5-year mortality as long term were evaluated.ResultsThree months and 5 years mortality rates for 1064 patients were analyzed. We showed that hypoalbuminemia and thyroid hormone index had statistically significant effects on short and long-term mortality. According to ROC analysis it was demonstrated that the scoring system including biochemical parameters such as thyroid hormone index and serum albumin level was more significant for 3-month mortality. In addition, both scoring systems are equal in demonstrating long-term mortality.ConclusionThyroid hormone index and albumin could improve the prognostic performance of the original Charlson Comorbidity Index in short term mortality. The combined score may offer improvements in comorbidity summarization over existing scores.

Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of ovulation induction with exogenous gonadotropins. Pleural effusion and abdominal ascites frequently accompany this syndrome. In this paper, we present the case of a 22-year-old female patient who was admitted to our clinic with the complaints of sudden chest pain and dyspnea and was treated with ovulation induction. Exudative pleural effusion and ascites were determined in the patient. Pelvic ultrasonography revealed enlarged ovaries with numerous follicular cysts compatible with ovarian hyperstimulation syndrome (OHSS). Her estradiol level was >5054 pg/ml. The diagnosis of OHSS was established after elimination of other causative factors of polyserositis (pleural effusion and ascites). The disappearance of pleural effusion and ascites spontaneously in a week supported our diagnosis. Herein, we aimed to emphasize that OHSS should be considered in the differential diagnosis of polyserositis in young female patients with a history of ovulation induction history. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 56-9)

Background: Recent studies showed a high frequency of low bone mineral density (BMD) in HIV-infected patients and no reports have been issued in Turkey. Our aim was to evaluate BMD and risk factors for osteopenia/osteoporosis in HIV-infected patients that attended an outpatient clinic in Istanbul, Turkey. Method: In order to determine the prevalence of BMD, 126 HIV-infected patients had been studied with dual energy X-ray absorptiometry (DEXA). The association between BMD and age, gender, body mass index (BMI), habits, 25(OH)vitamin D, HIV RNA, CD4 lymphocyte nadir, using and duration of highly active antiretroviral treatment (HAART) were investigated by using multivariate analysis. Results: Median age was 40.1 years (range, 20–70); 84% were male; 35.7% patients had AIDS, 63.5% were treated with HAART. Osteopenia and osteoporosis were diagnosed in 53.9% and 23.8%, respectively. Mean plasma HIV RNA was 5.2 (SD 1.0) log10 copies/mL and CD4 lymphocyte nadir was 313.8 (SD 226.2)/mm3. Factors associated with bone loss were high viral load (p = 0.034), using (p = 0.033) and duration of HAART (p = 0.008). No correlation had been seen between sex and osteopenia/osteoporosis (p = 0.794). However, males showed higher rates of osteoporosis than females (p = 0.042). Conclusions: Our results show a very high prevalence of bone mass reduction in Turkish HIV-infected patients. This study supports the importance of both HIV and antiretroviral therapy in low BMD. Keywords: Osteopenia/osteoporosis, HIV/AIDS, Prevalence, Risk factors

BACKGROUND: Recent studies showed a high frequency of low bone mineral density (BMD) in HIV-infected patients and no reports have been issued in Turkey. Our aim was to evaluate BMD and risk factors for osteopenia/osteoporosis in HIV-infected patients that attended an outpatient clinic in Istanbul, Turkey. METHOD: In order to determine the prevalence of BMD, 126 HIV-infected patients had been studied with dual energy X-ray absorptiometry (DEXA). The association between BMD and age, gender, body mass index (BMI), habits, 25(OH)vitamin D, HIV RNA, CD4 lymphocyte nadir, using and duration of highly active antiretroviral treatment (HAART) were investigated by using multivariate analysis. RESULTS: Median age was 40.1 years (range, 20-70); 84% were male; 35.7% patients had AIDS, 63.5% were treated with HAART. Osteopenia and osteoporosis were diagnosed in 53.9% and 23.8%, respectively. Mean plasma HIV RNA was 5.2 (SD 1.0) log10 copies/mL and CD4 lymphocyte nadir was 313.8 (SD 226.2)/mm³. Factors associated with bone loss were high viral load (p = 0.034), using (p = 0.033) and duration of HAART (p = 0.008). No correlation had been seen between sex and osteopenia/osteoporosis (p = 0.794). However, males showed higher rates of osteoporosis than females (p = 0.042). CONCLUSIONS: Our results show a very high prevalence of bone mass reduction in Turkish HIVinfected patients. This study supports the importance of both HIV and antiretroviral therapy in low BMD.