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Objective: C-reactive protein (CRP) is an acute-phase protein that is widely used and can be elevated in many conditions that lead to acute inflammation, including infectious diseases. In this study, we aimed to determine the rate of presence of an infectious disease in patients who were consulted because of a high CRP level. Methods: Inpatients and outpatients consulted to the Infectious Diseases and Clinical Microbiology (IHCM) Clinic between January and March 2022 because of high CRP levels were included in the study. The anamnesis, physical examination, and laboratory findings of the patients were recorded, and the existence of an infectious disease was investigated. Results: 124 patients were referred for consultation during the study period. CRP levels of 6 (4.9%) patients were within average reference values; the remaining 118 patients were included in the study. Of the 118 patients, 54 (45%) had clinical complaints consistent with an infectious disease. A focus of infection was detected in only 49 (42%) patients. We found that there was a significant relationship between the presence of symptoms consistent with an infectious disease and the presence of a positive physical examination finding with the presence of an infectious focus (p<0.05) Conclusion: In this study, we determined that more than half of the patients for whom consultation was requested due to high CRP levels did not have an infectious disease. We think that unnecessary consultation burden can be avoided by detailed clinical evaluation of the patients before referring them for consultation by only looking at the CRP results. [ABSTRACT FROM AUTHOR]

Objective: To reveal the characteristics of patients in need of neurosurgery by examining neurosurgery consultations within the emergency department (ED) admissions of a tertiary academic hospital. Methods: This is a retrospective, single-centre observational study. Patients admitted to the ED between 01.01.2022 - 31.12.2022 and consulted to the neurosurgery department were identified through the hospital computer system and included in the study. The demographic information of the patients, mode of admission to the ED, the reasons for admission, the time of admission, the number of brain computed tomography (CT) scans, whether they underwent surgery or not, and the mortality results were recorded. Results: A total of 441 neurosurgery consultations were examined. Fall 35.6% (n=157) and traffic accident 16.6% (n=73) were the most common reasons for consultation. It was observed that 92.5% (n=408) of the patients had a brain CT scan, and 19.5% (n=86) had two or more brain CTs. It was determined that 12.7% (n=56) of the patients consulted to neurosurgery were operated on, and 4.1% (n=18) of the patients' hospital admissions resulted in death. Only 53.7% (n=237) of the patients who underwent neurosurgery consultation were discharged from the ED. It was determined that significantly more Neurosurgery consultations were requested during working hours (p = 0.013). Conclusions: Most consultation calls from the ED to neurosurgery are for trauma patients. Brain CT examination is frequently used in neurosurgical patient evaluation. As a result of the consultations, almost half of the patients are hospitalized. Emergency physicians can select patients who need neurosurgery well. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to evaluate the reasons for visits, demographic and clinical characteristics of patients, the methods of approach to these patients who visited the pediatric emergency service and were consulted to ophthalmology. Material and Methods: The files of patients consulted to the Ophthalmology Clinic from Pediatric Emergency Department were analyzed retrospectively. Age and gender distribution of patients, complaints at the time of visits, clinical characteristics, diagnoses, diagnostic examinations and treatment methods were recorded. Results: Of the 241 patients, 164 (68.0%) were male and 77 (32.0%) were female. The median age was 11.0 (3.0-15.0) years. According to age groups, the highest number of patients was in the 12-17 age group with 117 (48.5%) patients. The most common complaints were foreign body in eye with 30.3% (n=73), eye redness with 10.8% (n=26), sticky eye with 8.3% (n=20) and eyelid swelling with 8.3% (n=20). The most common diagnoses were foreign body (31.1%, n=75), conjunctivitis (26.1%, n=63) and corneal epithelial defect (10.0%, n=24). Considering the distribution of diagnoses by age groups, conjunctivitis was the most common in the 0-5 and 6-11 age groups, foreign body in the 12-17 age group. While medical treatment was given to 59.3% (n=143) of the patients, intervention under local anesthesia was performed for 29.5% (n=71) of the patients. Of the seven patients that were hospitalized, five of them were treated under general anesthesia and two of them received surgical operations. Conclusion: Pediatric emergency visits with eye complaints in children were most common between 12-17 years of age and the most common cause was foreign bodies in the eye. All hospitalized patients were 0-5 years old and the most common reason for hospitalization was foreign bodies. Clinicians' awareness should be increased on common pediatric eye emergencies accordingly. [ABSTRACT FROM AUTHOR]

Objective: A limited set of common skin problems leads to a disproportionate percentage of consultations that, in addition to the economic burden and cost, will lead to a loss of physician time and confidence in the necessity and importance of counseling, but so far, written documentation. There is no information about the frequency of various skin diseases in hospitalized patients. Therefore, our goal is to investigate the frequency of skin diseases in dermatological consultations requested from other departments of teaching hospitals in Mashhad, Iran. Material and Methods: This cross-sectional was done over six months. We used basic information, including demographic information, cause of hospitalization and primary underlying disease, the reason for consultation, description of skin lesion, diagnosis of the requesting physician, the importance of counseling or the impact of counseling on the treatment process, the preclinical results and the final diagnosis by dermatologist and entered into the checklist. Results: There were 200 patients in this study. The most common skin diseases in the requested consultations were a drug reaction, psoriasis, vasculitis, and dermatitis. Most specialists seeking counseling were internal medicine, rheumatology, and neurology. The consulting physician’s diagnosis was correct in 52 patients. According to the dermatologist, 40 consultations were very important, 129 consultations were important and 31 consultations were insignificant. Conclusion: Our study showed that dermatology consultation was effective in 84.5% of cases in the diagnosis and treatment of patients, and only in 26% of cases, the diagnosis of primary care specialists was correct. [ABSTRACT FROM AUTHOR]

Objective: Pediatric neurology opinion is one of the most frequently requested consultations in emergency service practice. Symptoms and/or signs such as headache, altered consciousness, seizures, and focal neurological deficits are the most common consultation reasons. We aimed to retrospectively evaluate patients who were consulted with the pediatric neurology department in the pediatric emergency service. Method: This is a descriptive cross-sectional study in which the consultation notes of patients who presented to the pediatric emergency service and required a consultation with the pediatric neurology department between June 2016 and November 2019 were analyzed retrospectively. Results: The number of the consulted patients was 1,265. Sixteen patients left the hospital after their parents signed treatment and examination rejection form, 1,249 consultations were included. The most common reasons for consultation were seizure, routine follow-up of patients that receive home mechanical ventilator support, and headache. The rate of emergency neurological pathologies detected in brain computed tomography and magnetic resonance imaging was 1.7%. The most common electroencephalographic abnormality was focal epileptic discharges. Consultation rate requiring emergent intervention was 14.8% and status epilepticus, central nervous system infections, intracranial masses were the most common causes. Conclusion: The most common reason for consultation was seizure. The rate of consultations requiring acute intervention was low. We think that the emergency service admissions of patients that need examination and treatment in the outpatient clinic may harm the routine functioning of the emergency service. Community education for the use of the emergency room only when necessary is essential. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the clinical, demographic, and diagnostic characteristics of pediatric patients consulted to the dermatology department. Methods: Patients who were consulted to the dermatology department from pediatric clinic of Konya City Hospital between January 2021 and August 2021 were scanned retrospectively. The demographic data of the patients, the pediatric department requesting consultation, their complaints at admission, the reasons for asking for consultation, and the diagnoses they received as a result of the consultation were recorded. Results: A total of 296 patients, 150 (50.7%) females and 146 (49.3%) males were evaluated. Median age of patients was 5.5 (1.5-10.5) years. The outpatient clinic was seen to have made the most requests for consultation. The most frequent complaints on presentation were redness of the skin in 168 (56.8%) cases and itching in 36 (12.2%). The five most common diagnoses made as a result of the consultation were unspecified dermatitis in 47 (15.9%) cases, scabies in 34 (11.5%), insect bite in 17 (5.7%), atopic dermatitis in 13 (4.4%), and seborrheic dermatitis in 13 (4.4%). When the diagnoses were examined according to the age groups, unspecified dermatitis was usually seen in the 0-2, 6-11, and 12-18 years age groups and insect bite was more common in the 3-5 years age group. Conclusion: The establishment of effectively functioning consultation mechanisms not only facilitates a correct diagnosis for the patient and appropriate treatment, but also can shorten the length of hospital stay for patients and can reduce economic costs. [ABSTRACT FROM AUTHOR]

Objective: In hospitalized children and adolescents recognition of psychiatric symptoms, timely intervention and treatment are quite important. In this study, it was aimed to examine the characteristics of child and adolescent psychiatry consultations in a training and research hospital. Material and Methods: The psychiatric consultations of the child and adolescent inpatients between May 2016- October 2018 were assessed retrospectively. Demographic and clinical characteristics were analyzed using SPSS (Statistical Package Program for Social Sciences) 17.0. The compliance of continuous variables to normal distribution was tested using Kolmogorov-Simirnov test, Mann Whitney U test was used for comparisons. Categorical variables were expressed in terms of frequency (n) and percentage (%) and compared using the Pearson chi-square test. p values < 0.05 were regarded as statistically significant. Results: 66.9% (n = 85) of 127 children and adolescents evaluated within the scope of the study were females. 78.7% of the cases were in adolescent age group (13-17). Among the clinics that requested psychiatric evaluation, it was found that the highest rate of consultation was requested from the pediatric department with 93.7% (n = 119). Considering the reasons for requesting a consultation from the cases, it was found that the most requested consultation reason was the evaluation of suicide attempts (55.1%, n = 70). In the cross section evaluated, 19.7% (n = 25) of the cases were found to have at least one psychiatric disorder. It was found that at least one psychotropic drug was recommended to 18.1% of the cases. Conclusion: The importance of the Consultation-Liaison Psychiatry unit was highlighted in our study. Increasing awareness in the field of Consultation-Liaison is considered as a positive development, but it is thought that the services in this area should be improved more. Considering the different results found in the studies conducted in our country, to create a common language and algorithm in the field of consultation-liaison is thought to be important. [ABSTRACT FROM AUTHOR]

Summary Aim: This study was designed to evaluate the consultations that were requested from a public hospital’s emergency department to the department of chest diseases (DCD). Methods: Patients who were admitted to the state hospital emergency department and who were consulted to DCD were included in the study. Clinical features of patients were recorded in the data collection form. Patients who voluntarily left the hospitals, who has missing file data and who were not evaluated by the chest diseases specialist for any reason despite consultation were requested, were excluded from the study. Results: 280(53.9%) male and 239(46.1%) female patients with a mean age of 72.8±14.4 were included in the study. The most common concomitant disease were cardiovascular diseases, and the most common complaint for presentation was dyspnea. Chest diseases consultations was requested most frequently due to pneumonia and exacerbation of chronic obstructive lung disease. The response time of pulmonologists for urgent consultations was 93.8±127.3(1-837) minutes. 20%(104) of the consultations requested from the emergency department consisted of patients in terminal period of a disease. Conclusion: It was observed that a significant part of the patients were at advanced age and in need of care. It was concluded that the most common reason for hospitalization was pneumonia. [ABSTRACT FROM AUTHOR]

Objective: In the literature review, it was seen that there was no consultation-liaison psychiatry study that took the data of Elazığ province on the basis of one year. The aim of this study is to investigate the patients› demographic data, physical-psychiatric diagnosis and management by retrospectively looking at the psychiatry consultations requested within a one-year period. Materials and Methods: The data of the inpatients at the age of 18 and above in our hospital or who applied to the emergency department as outpatients were examined from the hospital registration system. Sociodemographic data such as age, gender, the name of the department requesting consultation, diagnosis of the main hospitalization in these departments and the psychiatric diagnosis were recorded on a structred form. Diagnostic evaluations were made according to DSM-5 criteria. Descriptive statistical analyzes were performed for the data examined in the study. Results: Psychiatric consultation was requested for 961 patients in total. 511 (53.2%) of the patients were female and 450 (46.8%) of them were male. The mean age for females was 53.65±21.5 years and 57.59±21.38 for males. 23 (2.4%) of the patients applied to the emergency department as outpatients. 204 (21.2%) of the patients were treated in intensive care unit, 280 (29.1%) in surgery ward and 454 (47.3 %) of them were treated in internal medicine wards as inpatient. The most frequent causes of psychiatric consultations were evaluation of the patients without indicating any reason for consultation referral (%68), anxiety (%7), insomnia (%5) and pre-operative psychiatric evaluation (%5). Endocrinological diseases such as diabetes (DM), hypertension (HT) (n = 228, 23.7%), diseases associated with chest diseases such as COPD (chronic obstructive pulmonary disease), asthma (n = 165, 17.2%) were the most common accompanying physical diseases. As for psychiatric diagnoses made according to DSM-5 diagnostic criteria; there were anxiety disorders in 409 (42.6%), depressive disorder in 131 (13.6%), adjustment disorder in 70 (7.3%) individuals were the most common diagnoses. Among all patients 68.5% were treated with antidepressants, 4.7 % with antipsychotics, 19.8 % of were offered to be followed up without drug treatment. 123 (12.8%) individuals were found to have attempted to suicide. 71 (57.73%) of the patients were female and 52 (42.27%) of them were male. The mean age of the patients was 30.64±5.64. The most common diagnoses were found to be depressive disorder and anxiety disorder. Conclusion: In our study, the concultations most frequent received from are the chest diseases department and the internal medicine departments. The most frequent cause of requirement of the concultations is psychiatric examination without any spesific reason. Anxiety and depressive disorders are the most common disorders diagnosed after psychiatric evaluation. This study is to be the first study examining the psychiatric consultations in the province of Elazığ city. The aim is to compare the results of the present study with the research conducted in other provinces and to lead the psychiatric approaches. [ABSTRACT FROM AUTHOR]

Objective: The many authors claim that poor communication may lead to bad consultations and patient results, but there is not enough evidence to support this argument. In this study, the aim was to determine whether consultation training makes a difference in the consultation process and patient outcomes. Method: This prospective, pre-/post-training study was conducted from June 1, 2019 to August 12, 2019 in an adult emergency department (ED). A feedback form with 9 questions related to the communication styles of emergency physicians (EPs) and their consultation processes was filled out by consultants. ED and hospital length of stay, in-hospital mortality, and additional requests were also noted. The validated 5Cs consultation model was used for training. Results: In the study, 724 of 1,295 eligible consultations (55.9%) were evaluated by consultants. The median scores of 7 questions related to the consultation processes and communication styles of the EPs increased after training, while there was no difference in patient outcomes or additional requests. In subgroup analyses, the median score of only 1 question increased in the internal consultations after training, while increases were noted for scores on 6 questions relating to surgical consultations. Similarly, there was no significant difference related to patients' outcomes and additional requests in these subgroup analyses. Conclusion: Consultation training had positive effects on the consultation processes and communication styles of the EPs. However, there was no difference in patient outcomes. Nevertheless, we believe that there should be communication skills training in countries that don't already have this in place. [ABSTRACT FROM AUTHOR]

Objective: Dermatological complaints can be seen frequently in hospitalized patients. During their inpatient, new dermatological lesions may develop, as well as exacerbate dermatological diseases that known before. Thus, the importance of inpatient consultations is increasingly. There are a limited studies in the literature that evaluating the dermatology consultations requested during hospitalization of pediatric patients. The purpose of our study was to describe the dermatology consultations in hospitalized pediatric patients. Material and Methods: A total of 137 patients consulted to dermatology clinic from the pediatric service over a period of four years were included in this study. The data were collected retrospectively from records. Results: Consultations were requested from general pediatric service. The most common primary diagnosis of inpatient pediatric patients was lung disease. The most common dermatological diagnosis in 137 patients were allergic disease followed by skin infections. Skin biopsy was performed on 28 patients by dermatology to aid for diagnosis. In evaluating the consistency between the pre-diagnosis of our clinic before the consultation and the dermatology diagnosis after the consultation, 32 patients were diagnosed differently. Conclusion: Skin lesions are frequently encountered in patient follow-up by pediatric health and disease specialists. At the same time, a significant part of the patient group of dermatologists is pediatric patients. Therefore, the cooperation of the two clinics is important in terms of diagnosis and treatment efficiency. One of the ways to create a working environment and cooperation that contributes to education between pediatrics and dermatology clinics is request a consultation. [ABSTRACT FROM AUTHOR]

Objective: Patients who come to the emergency department with dermatological complaints are generally referred to polyclinics. This practice increases the rate of correct diagnosis and treatment. It also reduces the workload of the emergency service. In this article, we wanted to examine the patients who applied to the emergency department and referred to our outpatient clinic but had any dermatological emergencies. Material and Methods: Patients between August 2018 and February 2020 were retrospectively evaluated from computer records and outpatient doctor records. In diagnoses were divided groups like urticaria, drug eruption, viral rash diseases, dermatitis, insect bites, infective conditions and pruritus. Results: 61.1% of the patients referred from the emergency service to our outpatient clinic were female and 38.9% male. Total number of patients was 72. The mean age was 39.94±14.10 (18-68) years. Twenty-six (36.1%) patients urticaria, 12 (16.7%) patients dermatitis, 12 (16.7%) patients pruritus, 7 (9.7%) patients infective conditions, 6 (8.3%) patients drug eruption, 5 (6.9%) patients had viral eruptions diseases and 4 (5.6%) patients were diagnosed with insect bites. The youngest group was the patients diagnosed with insect bites with an average of 32.75±15.34 years and the oldest group was the group diagnosed with viral rash with an average of 52.00±14.68 years. The average complaint duration of all patients was 2.47±1.85 (1-10) days. Conclusion: It may be useful to refer patients to dermatology outpatient clinics who are not dermatological emergencies in during working hours. [ABSTRACT FROM AUTHOR]

Objetives: In this case report, the role of the laboratory in the diagnosis process of the patient was treated with methotrexate (Mtx) who was diagnosed with ectopic pregnancy by endometrial biopsy as a result of the exclusion of the possibility of phantom HCG following the patient with βHCG values was discussed. Case presentation: Our 25-year-old female patient admitted to our hospital obstetrics and gynecology outpatient clinic with irregular menstruation was evaluated with a pre-diagnosis of pregnancy. The hCG level was examined and ultrasonographically evaluated by the clinician. In the initial evaluation of the 25-year-old patient, the HCG concentration of 47 mIU/mL was determined. Conclusion: Laboratory specialists should be aware of potential problems in hCG measurement. Clinicians and laboratory specialists should always be on consultation to solve clinical problems. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficiency of electroencephalography (EEG) requested at the consultation. Methods: EEGs for which consultation was requested in one year were analyzed retrospectively. Neurology consultation notes, EEG forms, compliance with EEG findings were examined for each patient. Demographic data, requested unit, pre-diagnosis, final diagnosis were recorded. EEG results were divided into 3 groups:1)normal, 2)EEG with epileptiform anomaly (EEG-EA),3)EEG with nonepileptiform anomaly (EEG-NE). EEGs were also evaluated for their indications and contribution to diagnosis. Results: A total of 261 EEG recordings of 239 patients (133 men, average age 56.44 (18-90) ) were examined. 30.5% of the registered patients had a history of neurological diseases. EEGs were requested from 36.4% intensive care units and emergency departments, 51.5% internal branches, 12.3% surgical branches. Preliminaries were seizures in 42.5%, alertness/encephalopathy in 17.2%, syncope in 5.7%, nonconvulsive status epilepticus (NCSE) in 10.3%. 55% of EEGs were considered normal. 37.5% were in EEG-NE, 8.4% in EEG-EA. 91.6% of patients were imaged, 52.5% were pathological. Focal imaging pathology and EEG findings were compatible in 63% of patients with pathological EEG findings. EEG was pathological in 64.5% of the 127 patients requested with appropriate indications. 80% of EEG was thought not to contribute to the definitive diagnosis. Discussion: Male and advanced elderly people with neurological disease were preferred for EEG. Appropriate indication with a desired high probability of detection of pathological EEG. It is important that the doctor who evaluates the inpatient patient makes more careful decisions in terms of unnecessary process, resource and time wasting. [ABSTRACT FROM AUTHOR]

Objective: In this study, it was aimed to evaluate the psychiatric consultations required for inpatients in an education-research hospital and to examine the correct recognition rates of psychiatric diseases by other physicians. Method: Psychiatric consultations for patients who were hospitalized at Ankara Numune Training and Research Hospital except psychiatry and emergency department had been retrospectively screened between 01/04/2016 - 01/10/2016. Results: During this period, 27457 patients were hospitalized in Ankara Numune Hospital apart from the emergency department and psychiatric services, and a total of 544 (1.9%) psychiatric consultations were requested. Psychiatric consultations were most frequently requested with the reason of agitation (17.5%); 16.9% did not specify any reason. Anxiety (8.3%), drug treatment regulation (6.1%), delirium (5.5%), sleep problems(5.3%) and pre-transplant evaluation (4.4%) are other common causes of consultation. The highest rate of psychiatric consultation was in the bone marrow transplant unit (21.0%) followed by infectious diseases (9.6%), intensive care (9.5%) and physical medicine and rehabilitation (9.0%). There was no psychiatric disease in 29.4% of the requested consultations. 149 patients (27.4%), were diagnosed with anxiety disorder,70 patients (12.9%) with delirium, 37 patients (6.8%) with depression, 22 patients (3.7%) with alcohol / substance use disorder, 20 (3.7%) patients with psychotic disorder, 15 patients (2.8%) with trauma related disorders, and 2 patients (0.4%) were diagnosed with somatization disorder. Delirium had the highest rate of recognition by primary medical care providers (89.5%), followed by anxiety disorders (55.6) and alcoholsubstance use disorders (53.3%). Discussion: In this study, psychiatric consultation rates were found to be low, psychotic disorders and somatization disorders are not well recognized even though delirium is well known by primary medical care providers. [ABSTRACT FROM AUTHOR]

Emergency department (ED) consultation is an important part of acute patient care and one of the major determinants of ED length of stay (LOS). ED consultations between physicians who may not be in the same location frequently, require a tool to reach out one another and communicate. This paper reviews the historical change and development of consultation tools. The literature on ED consultation methods have been accumulating for the last two decades as the diversity of these methods has increased with technology. Most of the studies demonstrate that high tech systems are useful and safe to reach the consultant and share medical information flow. Moreover, the future of the area offers new developments regarding consultation tools that are hard to imagine yet like augmented reality. [ABSTRACT FROM AUTHOR]

Background: In this study, we aimed to evaluate the results and the results of the consultations requested by other branch physicians in order to get the diagnosis and treatment suggestions about the patients with a pathology which is thought to be related to the Ear- Nose- Throat Diseases clinic. Methods: Between January 2017 and January 2018 in our hospital, 500 patients who were consulted from the Ear- Nose- Throat Diseases clinic were analyzed retrospectively. The mean age of the patients was 46 (1 -100), 298 were male (59.6%) and 202 were female (40.4%). Clinics seeking consultation, causes of consultation request, symptoms found in consultation cases, decisions after consultation and procedures were recorded. Results: The clinics that requested the most consultations from the Ear-Nose-Throat Diseases clinic were found to be Emergency Service (403 patients- 80.6%) and as Inpatient Internal Clinic and Surgical Services. The most frequent reasons for consultation were sore throat (90 patients- 22.33%), ear pain (70 patients- 17.36%), and nosebleeds (60 patients- 14.88%). Ear-Nose-Throat (K.B.B.) Disease consultation was requested in 1% of all patients, 4% of the operation was performed with local anesthesia, 9% of the elective surgery was recommended. Conclusion: The use of adequate number of specialist health personnel in clinics such as Emergency Service, increasing the knowledge and experience of the related branch expertise and being selective about the consultation will reduce the number of unnecessary consultation and workload. [ABSTRACT FROM AUTHOR]

Objective: The aim of this research was to assess the characteristics of the consultations required in a psychiatric department of a university hospital, and the distribution of psychiatric disorders in hospitalized patients and patients admitted to the emergency room. Method: In the study, the data of 539 patients 18 years or older (48.67 ± 20.91 years) (46.8% women) who were hospitalized and who presented to the emergency room between 01/01/2015 and 31/12/2015, and for whom a psychiatric consultation was requested were recorded onto a structured form. Patients' electronic databases were reviewed retrospectively for the specified date range. Descriptive statistical analyzes (frequency of data, distribution, mean, standard deviation) were performed for the data examined in the study. Results: Medical departments (42.9%), surgical departments (31.7%) and the emergency medicine department (25.4%) were the most frequently psychiatric consultation requesting departments. The most frequent requests for consultation were agitation (15.4%), depressive symptoms and signs (14.7%) and suicide attempts (12.2%). The most frequent psychiatric diagnoses were depressive disorders (19.5%), delirium (18.2%) and schizophrenia and other psychotic disorders (7.4%). Musculoskeletal diseases (17.4%), mental disorders (15.0%), oncologic diseases (14.1%) and suicide attempts (12.2%) were the primary diagnoses of patients. Discussion: Consultation and liaison psychiatry services have an important role in our relationship with other departments in medicine. Priority to training of depressive disorders, delirium and suicide attempts should be offered to healthcare providers working in these departments. [ABSTRACT FROM AUTHOR]

Background: Medical consultation is defined as the exchange of views by more than one physician in order to diagnose or treat a disease. Counselor physician is called 'consultant' and the person executed the consultation is called a 'primary treating' physician. The medical genetics department is one of the departments that require the largest number of consultations from patients. In this context, we aimed to evaluate the consultations performed by medical genetic physicians both as consultant and primary treating physician in the light of additional parameters. Material and Methods: Between January 2017 and December 2017, 851 people evaluated in the outpatient clinic were included in the study. The department on consultation and the number of consultations requested are noted. There was no indication limitation in our study. Misplaced and repeated consultations were excluded from the study and only written consultations were included in the study. The results were evaluated using the SPSS 25.0 program. Results: The mean age of the participants was 11.27 ± 8.54. The age range of the individuals was 0-68. It was observed that more frequent consultations were requested from the internal medicine and the patients evaluated after the consultation. It has been observed that the pre-and post-diagnosis consultation request numbers are close to each other. Conclusion: It has been emphasized that the medical geneticists should work more closely with the which departments. The importance of the contributions of teachers and dentists in terms of medical geneticists has been pointed out. [ABSTRACT FROM AUTHOR]

Background: The purpose of consultation is to obtain the necessary information for the follow-up and treatment of the patient from the physicians in the relevant specialty. The list of hyperbaric medicine indications is quite extensive and it is collaboration with many departments. Material and Methods: 75 diabetic foot consultations of 53 patients were included in the retrospective study from the consultations sent to the Hyperbaric Medical Service between May 26, 2017 and May 26, 2018. Patients' personal information, diagnosis, duration of consultation request and answer, changes in laboratory parameters after the applications, consultations to be made to other departments recommended by hyperbaric medicine specialist were evaluated. Results: 49% of the patients were female, 51% were male and the mean age was 60.28 ± 10.8. 15.67% of the patients were Wagner 1, 30.34% were Wagner 2, 30.34% were Wagner 3, and 23.67% were Wagner 4 diabetic foot patients. 80% of these applications constitute of abscess drainage, debridement and dressing. There was a statistically significant decrease in CRP, WBC and sedimentation values of patients after consultation (p <0.05). Consultations made independently have improved the laboratory values, regardless of the duration of the response to the consultation and whether it is urgent(p> 0.05). Conclusions: Whatever the stage of the diabetic foot, while the patients who are diagnosed with diabetic foot diagnosis are being evaluated, it is absolutely to be consulted to the Hyperbaric Medical Clinic. It is thought that the hyperbaric medicine specialists treatment have contributed positively to the management of the wound. [ABSTRACT FROM AUTHOR]

Object: This study was conducted to evaluate child psychiatry consultations of patients which were stayed in different clinics in a university hospital. Methods: The records of the patients who were consulted in between 01.07.2016 and 31.12.2016 and was made diagnosis according to DSM5 was scanned restrospectively. The sociodemographic information of the patients, the diagnosis of physical illness, the clinic requested for consultation, the reason for the consultation, the psychiatric diagnoses determined in the consultation result and the psychiatric treatment process were analyzed by using the SPSS 15.0 program. Results: Psychiatric consultation was requested for 55 inpatient children within a six-month period. %63,6 of consulted cases was a girl, %36,4 of them was a boy and the average age was found as 13,2 ± 3,6. When the consultations were evaluated, it was determined that the 23,6% of the patients were consulted for suicide attempt and 83,6% of them had at least one mental disorder. The most common diagnosis was major depression in the rate of 36,4% and psychotropic treatment was recommended to 38,2% of evaluated cases because of the psychiatric disorder. Discussion: In our study, it was found that the consultation rates were low despite the rate of psychopathology (83,4%) was rather high in consulated children and adolescents. This suggests that the doctors who are working in non-psychiatric areas are having difficulty understanding and evaluating the psychiatric symptoms in children and that the cooperation among physicians should be increased so that psychiatric illnesses can be better recognized. [ABSTRACT FROM AUTHOR]

Pregnancy is a physiological state that is associated with various physiological skin changes and specific dermatoses. The purpose of this study was to evaluate the dermatologic problems of pregnants followed by obstetrics and gynecology clinic by analyzing dermatology consultations, retrospectively. The data, including dermatology consultations requested by obstetrics and gynecology clinic for pregnants between September 2011-May 2017 were screened. Sixty-one patients without any missing information were included in the study. The mean age of 61 cases was 30.66±6.61 years (19-43 years). Their gestational weeks varied between 5, and 40 weeks and 29 patients (47.5%) were primigravid, 32 patients (%52.5) multigravid and five patients (%8.2) were in postpartum period. The reason for asking consultations for two pregnants was the physiological change of pregnancy. Sixteen patients (26.2%) had pregnancy-specific dermatosis; 11 patients diagnosed with polymorphic eruption of pregnancy, four patients with intrahepatic cholestasis of pregnancy and one patient had pemphigoid gestationis. The pregnants with the diagnosis of gestational dermatosis were in their third trimesters (n=14) or postpartum periods. Forty-five pregnant patients or those in their postpartum period for whom consultations were requested (75%) had itching with or without a rash. There were three pregnant women who used drugs in the C, D and X pregnancy categories for consultation because of unplanned pregnancy and drug use. Pruritis was detected as the most frequent complaint. Infection and drug use that could affect maternal and infant health were attracting attention among the reasons for consultation request. [ABSTRACT FROM AUTHOR]

In the study, 88 dogs with acquired or congenital heart disease were assessed. Medical records including anamnesis, physical examination, thorax radiography, electrocardiographic and echocardiographic exams and treatment options of cases were also evaluated. The current study reflects the clinical and diagnostic applications including electrocardiography, thorax radiography and echocardiography in cases with heart disease and the significance of routine cardiac exams in geriatric cases during the diagnostic process. [ABSTRACT FROM AUTHOR]

Objective: The primary aim of this study is to evaluate the frequency and distribution of consultations relevant to infectious diseases at Emergency Service. Material and Method: Consultation requests from Emergency Service to Infectious Diseases and Clinical Microbiology were overviewed. The study was retrospectively performed at Ankara Training and Research Hospital between July 2014 and December 2014. All consultation requests by the Emergency Service were evaluated and distribution of consultations according to the clinics, and reasons for the consultation and hospitalization rates were investigated. Results: Within six months, a total of 1,399 patients were consulted by the Department of Infectious Diseases and Clinical Microbiology, accounting for 5.1% of all consultation requests. Most frequent consultation reasons were detected as lower respiratory tract infections (25.8%), fever etiology (25.8%), urinary tract infections (11.4%), and animal bite/rabies prophylaxis (10.4%). The hospitalization rate after consultation by infectious diseases clinic was found to be 10.1 %. Conclusion: According to these results, it is considered that more cooperation and educational activities are needed between the Emergency Service and Infectious Diseases specialists. [ABSTRACT FROM AUTHOR]

Objective: Plastic surgery is not confined to a specific organ system. As it can be performed along with other specialties, it is a custom to ask for the opinion of plastic surgeons in various situations. Under academic and medicolegal restrictions, professional opinions are demanded via "consultations." Material and Methods: In this study, consultations in 2014 asked from a plastic surgery clinic of an education and research hospital are retrospectively reviewed. Results: During 2014, from a total of 46,277 inpatients, 1124 consultations to the plastic surgery clinic were documented. The total number of patients who consulted was 438. Conclusion: In light of this situation, we believe that the curriculum of interclinical rotation programs should be re-evaluated and reshaped. [ABSTRACT FROM AUTHOR]

The incidence of geriatric patients undergoing surgical procedures has been increasing markedly as a result of increase in geriatric population. The anesthetic management of these patients should provide a better understanding of preoperative period and a better and smooth postoperative care, with a specific approach including physiological and psychological age -specific changes. We evaluated the consultations, interpretation, guideline recommendations and risk scoring systems in the geriatric population required during the postoperative period. [ABSTRACT FROM AUTHOR]

Giriş: Antibiyotiklere dirençli mikroorganizmalarla gelişen enfeksiyonlar tüm dünyada toplum sağlığını tehdit etmektedir. Bu hastalıkları tedavi edebilmek için elimizde kısıtlı sayıda antibiyotik mevcuttur. Akılcı antibiyotik kullanımı; morbidite ve mortalitenin azaltılması, direnç sıklığının düşürülmesi, yatış süresinin, hastane dışı tedavi süresinin ve toplam tedavi maliyetinin azaltılması ile hasta, sağlık sistemi ve toplum için vazgeçilmez bir uygulamadır. Akılcı antibiyotik kullanım yöntemlerinden biri antibiyotik kullanımını kısıtlama politikalarıdır. Ülkemizde yataklı tedavi kurumlarında uygulanmakta olan EHU (enfeksiyon hastalıkları uzman onayı) sisteminde A-72 kodu ile adlandırılan, tedavi başlangıcında EHU gerekmeyen ancak en geç ilk 72 saat içinde EHU alınması gereken antibiyotikler mevcuttur. Bazen bu antibiyotiklerin gereksiz kullanımı ile karşılaşılmaktadır. Bu çalışmada A-72 kodlu antibiyotiklerin kullanımına ilişkin istenilen konsültasyonların değerlendirilmesi amaçlanmıştır. Gereç-Yöntem: A-72 kodu içinde yer alan ve hastanemizde kullanılan seftriakson ve parenteral kinolonlar için sıklıkla EHU istemi yapan genel cerrahi ve göğüs hastalıkları klinikleri tarafından 01.12.2021-31.03.2022 tarihleri arasında istenen konsültasyonlar retrospektif olarak değerlendirildi. Hastaların epidemiyolojik verileri, yattığı klinik, uygulanmak istenen antibiyotik, tedavi öncesi kültür alınıp alınmadığı ve sonuçta verilen karar çalışma formuna kaydedildi. Bulgular: Çalışma periyodu içinde 189 hastadan istenen toplam 205 tane konsültasyon değerlendirildi. On altı hasta için rekonsültasyon mevcuttu. Hastaların yaş ortalaması 62,95±15,17(18-89), 70’i kadın (%37), 119’u erkekti (%63). Doksan bir hasta genel cerrahi, 98 hasta göğüs hastalıkları kliniğinde izlenmekteydi. En çok istem yapılan antibiyotiğin sefrtiakson (%70,7) olduğu görüldü. Tedavi başlanmadan önce 104 hastadan (%50,7) herhangi bir kültür örneği gönderilmemişti. Diğer hastalardan gönderilen örnekler kan, balgam, idrar, yara yeri ve diğer vücut sıvı kültürü idi. Konsültasyon sonucunda 100 (%48,8) hastada tedavinin kesilmesi, 75’inde (%36,5) devamı, 30’unda (%14,7) antibiyotik revizyonu kararı verildi. On beş hastadan ek tetkikler istendi. Birimlere göre sayı ve yüzdeler tabloda verilmiştir. Sonuç: Çalışmamızda antibiyotik kesilme oranının genel cerrahide en yüksek olması gereksiz antibiyotik kullanım oranının bu birimde yüksek olduğunu düşündürmüştür. Yine aynı birimde tedavi öncesi kültür alma oranı da düşük saptanmıştır. Uygunsuz antibiyotik kullanımı direnci, mortaliteyi, yan etki ve maliyet gibi pek çok olumsuz durumu beraberinde getirmektedir. Antibiyotiklerin akılcı kullanımı sadece enfeksiyon hastalıkları uzmanlarının değil sağlık sistemindeki tüm paydaşların çabası ile mümkün olacaktır. Bu konuda bölgesel, ulusal ve küresel politikalar üretmek bir zorunluluktur. [ABSTRACT FROM AUTHOR]

Objective: Main objective was to address the issue by presenting the reasons of child and adolescent psychiatry consultations, clinical and socio-demographic characteristics of the cases and the treatments suggested. Methods: Patient information related to the consultations requested from the department of child and adolescent psychiatry by the clinics of pediatric, and other clinics in the Afyon Kocatepe University, Faculty of Medicine between February 2014 and January 2015 were retrospectively screened. Results: In the past year, 137 child and adolescent psychiatry consultations were requested. 43.8% (n=60) of the cases were male, 56.2% (n=77) were female. While mean age was 10.9±4.3 years. Consultations were most often requested from the clinics of pediatric (27.8%; n=38), and pediatric intensive care unit (16.7%; n=23). Of the cases, 29.2% had not received any psychiatric diagnosis. Psychiatric diagnoses were mostly depressive disorder (12.4%), adjustment disorder (8.0%), and attention deficit hyperactivity disorder (7.3%). Medical treatment was administered to 70.2% (n=97) of the evaluated cases. Conclusions: Our study reveals that psychiatric disorders, mainly depressive disorder and adjustment disorders are frequently seen in patients with physical diseases. Outcomes of our study emphasized the merit of these consultation demands, and importance of collaboration between disciplines. Holding more educational meetings on this issue might contribute to enhancing the cooperation between clinics. [ABSTRACT FROM AUTHOR]

Suicide ideations, attempts and completed suicides are frequent situations in clinical practice of child and adolescent psychiatry. Besides, these situations especially are more common in adolescence period and suicide is one of the major causes of death for this age group. Just because of its easy accessibility, paracetamol (acetominophen) is a drug that is commonly used in suicidal attempts. Paracetamol toxicity is a fatal situation which is one of the most frequent causes of acute liver failure. Liver transplantation is the only option for treatment of acute liver failure. Transplantation from a living donor is the first option because of limited organ sources. In transplantation process, both donor and recipient must be evaluated psychiatrically. Child and adult psychiatrists must work in cooperation with organ transplantation team, in this emergency of which a race against time endures. Furthermore, unlike from adult psychiatrists, child psychiatrists have to evaluate candidate pediatric cases according to their developmental characteristics. In this article, we aimed to evaluate pretransplantational process of child psychiatry consultation in an adolescent who has hepatic failure due to paracetamol intoxication. We discussed the common and urgent medical and psychiatric situations that may be experienced in emergent transplantation cases. [ABSTRACT FROM AUTHOR]

Aim: In this present study, we aimed to identify and analyse most requested consultations which were sent from oncology department to other clinics and we also aimed to emphasise and take attention that clinical settings of cancer diseases are not only specific to oncology department but also should be considered systematically accompanied by the help and need of the other medical clinics. Material and Methods: A total number of 596 consultations from 399 patients in oncology department were retrospectively analysed in Diskapi Education and Research Hospital between January 2013 and July 2013. Results: Breast and colon cancer were the most frequent diagnosis among patients (29.1% and 16.8%, respectively). Radiology was the most frequently requested department for consultation in all patients (n: 94, 23.6%). It was found in this study that, male patients were mostly consulted to Cardiology (p:0.002) and Pulmonary Diseases department (p:0.003), while female patients were frequently consulted to Physical Treatment and Rehabilitation (p:0.0001) and Endocrinology clinic (p:0.05). Consultations to Physical Treatment and Rehabilitation and Radiology department (22.4%) were more frequent among patients with breast cancer. On the other side, consultations to General Surgery (n:21, 24%), Radiology (n:21, 24%) and Neurology (n:17, 20%) was the most common in patients with colorectal cancer. Conclusion: Even though this results are due to differences in frequencies of diseases and their complications in both sex and diagnosis groups, medical oncology is in close relationship with other clinic branches . As a result, malignant diseases should be taken into account systemically and multidisciplinary. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this study is to determine the impact of the expected increase in the volume of patient visits in the emergency department during holiday periods on physicians' tendencies regarding test and consultation requests as well as on the length of time patients stay in the emergency department. Methods The study groups included all of the patients who visited the emergency department during the nine-day public holiday (Eid al-Adha, a religious festival of sacrifice) celebrations and a nine-day non-holiday "normal" period. The patients' demographic information, reasons for their visits, comorbid diseases, whether or not they had undergone laboratory and screening tests, consultations, length of stay, and the way their visits ended were compared statistically. Results Of the 6353 patients enrolled in the study, 3523 (55.5%) were seen in the emergency department during the holiday period, while 2830 (45.5%) were seen during the non-holiday period (p<0.001). During the holiday period, there was a 1.9% decrease in laboratory test requests (p=0.108), a 7.7% increase in radiology examination requests (p<0.001), and a 1.2% increase in consultation requests (p=0.063). The patients' length of stay during the holiday period was 55.9±75.3 minutes and was 56.3±71.9 minutes during the non-holiday period (p=0.819). The length of time for the patients who underwent tests or consultations was 88.6±92.8 minutes during the holiday period and 92.6±87.5 minutes during the non-holiday period (p=0.224). Conclusions As expected, the number of patient visits to the emergency department increased during the holiday period, but this increase did not lead to a similar increase in test and consultation requests by the physicians, except for radiology examination requests. In addition, the length of time that patients stayed in the emergency department was not affected by the increase in the volume of patient visits during the holiday period. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to find the relevant factors of forensic medicine, child and adolescent psychiatry, and psychiatry fields' preferences in the forensic psychiatric assessment requests of forensic authorities. Method: Case records which are consulted to Erzurum Atatürk University Faculty of Medicine, Forensic Medicine, Child and Adolescent Psychiatry, and Psychiatry Departments between 01.01.2010 and 31.12.2010 were assessed retrospectively. Results: Of the 330 cases who were assessed, 54.2% (n=179) were male, 45.8% (n=151) were female, 54.8% were (n=181) child and adolescent, and 45.2% (n=149) were adult. In the light of our results, forensic authorities noticed the difference of choice between forensic medicine and child and adolescent psychiatry when consulting child and adolescent cases. Besides there was no difference for the choice between forensic medicine and psychiatry in the forensic psychiatric evaluation of adult cases. Discussion: It is thought that interdisciplinary approach which was formed by developing law practices of specialty area choice in the forensic psychiatric evaluation requests of forensic authorities is an important step for achieving accurate results. Conclusion: Evaluations in the area of forensic psychiatry should be made with cooperation of related disciplines. [ABSTRACT FROM AUTHOR]

Objective: To examine the causes and demographic characteristics of the patients, admitted to Uludağ University Medical Faculty Emergency Department with rheumatologic diseases and rheumatic complaints. Methods: Demographic data of the patients were obtained by examining the electronic files of the emergency department, in the one year period between February 2012 and February 2013 . Results: Total 3600 patients that admitted to emergency internal medicine room, 33 female, 18 male total 51 patients (1.7%) were associated with rheumatic diseases. Eight patients (15.8%) were over 65 years. The most frequently observed five symptoms were joint pain, diffuse body pain, fatigue, dyspnea and fever. Diagnosis of the patients were; 16 (31.3%) rheumatoid arthritis, 5 (9.8%) Behçet's disease, 5 (9.8%) systemic lupus erythematosus, 6 (9.8%) vasculitis, 3 (5.8%) ankylosing spondylitis and 3 (5.8%) familial Mediterranian fever. Six patients were consulted with the symptoms of arthritis. The most common 5 reasons for consultation were rheumatologic disease activity, pneumonia, urinary infection, neutropenia and fever. Thirty-one (67.8%) patients in the emergency department were evaluated by the second department. The most common additional consultations were requested from infection (n=13, 42%) and respiratory disease departments (n=6, 19%). Hypertension, diabetes mellitus, chronic renal failure or hyperlipidemia has been identified in 14 (27.4%) patients as the second chronic comorbid disease. Thirty-six (76%) patients were hospitalized and 15 (24%) patients were discharged. Exitus was observed in one patient during hospitalization. Conclusion: The incidence of rheumatic diseases that admitted to the emergency departments are less than the other internal medicine departments such as oncology, gastroenterology or nephrology. In recent years, with the recognition of rheumatic diseases and higher number of immunosuppressive therapies, rheumatic diseases are increasing in emergency departments. Infections and disease activity are the most common causes of admission. Hospitalization ratios are high in patients with rheumatic diseases from the emergency unit. [ABSTRACT FROM AUTHOR]

Objectives In this study, we aimed to determine the causes of overcrowding in the Emergency Department (ED) and make recommendations to help reduce length of stay (LOS) of patients in the ED. Methods We analyzed the medical data of patients admitted to our ER in a one-year period. Demographic characteristics, LOS, revisit frequency, and consultation status of the patients were determined. Results A total of 163,951 patients were admitted to our ED between January 1, 2013, and December 31, 2013. In this period 1,210 patients revisited the ED within 24 hours. A total of 38,579 patients had their treatment in the observation room (OR) of the ED and mean LOS was found to be 164.1 minutes. Cardiology was the most frequently consulted specialty. Mean arrival time of the consultants in ED was 64 minutes. Conclusions Similar to EDs in other parts of the world, prolonged length of stay in the ED, delayed laboratory and imaging tests, delay of consultants, and lack of sufficient inpatient beds are the most important causes of overcrowding in the ED. Some drastic measures must be taken to minimize errors and increase satisfaction ratio. [ABSTRACT FROM AUTHOR]

Introduction: Consultation-liaison psychiatry is a field of psychiatry which investigates associations among clinical medicine in general, different fields of specialties and psychic and psychosocial entities. This psychiatric discipline deals with diagnosis, treatment, follow-up of psychiatric, and psychosocial disorders associated with physical diseases. The objective of this study was to review causes of consultations requested from departments of child and adolescent mental health, and diseases (PAMHD), sociodemographic data of the cases, and treatment approaches related to these cases. Materials and Methods: Patient information related to the consultations requested from the department of child and adolescent psychiatry by the clinics of emergency medicine, and other clinics in the Uludag University, Faculty of Medicine (UUFM) between January 2012 and January 2013 were retrospectively screened. Results: PAMHD consultations were requested from 0.48% of the cases in the UUFM who referred to the outpatient clinics of pediatric emergency, and 3.25% of the inpatients aged less than18 years. A total of 275 cases (females, 51.5%; and males, 48.5%) with a mean age of 13.5±4.23 years were evaluated. Consultations were most often requested from the clinics of pediatric emergency (27%), pediatric hematology (12.5%), and pediatric nephrology (12.5%) in decreasing order of frequency. Of the cases, 7.6% had not received any psychiatric diagnosis. Psychiatric diagnoses were mostly adjustment disorder (26.2%), depressive disorder (20.7%), and anxiety disorder (15.3%). Medical treatment was administered to 36% of the evaluated cases. Conclusions: Our study reveals that psychiatric disorders, mainly adjustment disorders and depressions, are frequently seen in patients with physical diseases. Apparently, screening studies performed have revealed annual increases in the number of consultations evaluated. Outcomes of our study emphasized the merit of these consultation demands, and importance of collaboration between disciplines. [ABSTRACT FROM AUTHOR]

Aim: As home health care centers develop in our country, expectations of patients and their relatives increase. This study was planned to show the most frequent reasons for application and the service given by a home health care center. Material and Methods: This is a descriptive study done screening the files. All patients visited by home health care center between January 01 and December 31, 2012 were recruited to the study. Repeated visits were excluded. All requests were included in the assessment even though there was more than one request. Results: During the study period, a total of 554 patients of 218 male (39,4%) and 336 female (60,6%) were visited. Mean age of patients was 72,7±16,4 years. The most 3 frequent reasons for application were medication use report (n=252; 45,5%), diaper report (n=197; 35,6%) and general examination (n=158; 28,5%) respectively. There was hypertension (HT) in 34,8%, stroke in 31,0%, Alzheimer in 19,3%, diabetes mellitus in 18,8% and heart diseases in 10,8% of patients. Consultations from other clinics weren't asked in 49,0% of patients. Consultations were asked mostly from specialists of neurology, social services and physical therapy and rehabilitation. Conclusions: According to our results, the most frequent requests from a tertiary home health care center were medication use report and diaper report that require specialists. As monthly visits for INR-blood tests and urine catheters make up a substantial number and evaluation do not need specialty, follow up by primary care would help to reduce the workload of tertiary hospitals. [ABSTRACT FROM AUTHOR]

AIM: The aim of the present study is to inquire into the evaluation and monitoring processes of the psychiatry consultations requested within the period of 4 years and 3 months in Suleyman Demirel University (SDU) Medical Faculty Children-Adolescent Mental Health and Disorders Department. METHOD: In-patients and out-patients monitored by the clinics of SDU Medical Faculty between 20 March 2008 - 04 June 2012 for whom psychiatry consultation is requested are included in the study. The requested consultations are evaluated retrospectively in this study. Data concerning which units the consultations have been requested from, the medical diagnoses of the patients, reasons for the consultation request, psychiatric diagnoses and treatments, and the monitoring processes and demographic characteristics are evaluated. RESULTS: The 71.4% of the cases are females (n:40) and the 28.6% are males (n:16). There are 56 cases that consist of children and adolescents. The 66.1% of the cases are in-patients and 33.9% are out-patients. The most frequent medical diagnosis is acute physical complaints (48.2%), and the most frequently observed reasons for consultation requests are suicide attempts (41.1%) and depressive symptoms (12.5%). It has been observed that among the patients for whom monitoring is advised, 66% have not attended to their monitoring sessions. CONCLUSION: It is important that child care physicians and mental health professionals to work in cooperation for the consultation process to function properly. It has been observed that most of the cases for whom monitoring is advised have not attended to their monitoring sessions and were not able to complete their treatments. It seems proper to inform the families about this matter and to take the necessary measures in the child psychiatry clinics where monitoring is to be conducted. [ABSTRACT FROM AUTHOR]

Bedside pulmonary consultations (BPCs) in Duzce Ataturk State Hospital during 3 month-period in January 2011-August 2011 were recorded prospectively in order to evaluate clinical characteristics of the cases. BPC were requested from 28.9% (44) emergency, 23.7% (36) general surgery, 14.5% (22) intensive care unit. The most frequent reasons for BPC were respiratory symptoms and radiological abnormalities in 51 (33.6%) and 35 (23%) of the cases, respectively. %26.3 of cases (40) had normal chest radiography and the most frequent radiological finding was cardiomegaly (15.8%). Computed tomography and pulmonary function testing were ordered in 13 (8.6 %) and 44 (28.9%) of the cases, respectively. Obstructive lung disease, normal respiratory system finding, pulmonary infection and a cardiac disease were diagnosed in 48 (31.6%), 43 (%28.3), 19 (12.5%) of the cases, respectively. A medical treatment was proposed to 86 patients (56.6%). BPCs from emergency service and inpatient clinics were frequently due to respiratory complaints and the most common diagnosis was obstructive lung disease. [ABSTRACT FROM AUTHOR]

Objectives: Recently, many treatment and rehabilitation programs have been developed to increase life quality of psychiatric patients. Nevertheless, comorbid medical problems of psychiatric patients are still being neglected. This may lead to unpredictable complications or exacerbation of the existing psychiatric disorder of the patient. Consultations of all psychiatric patients treated in a psychiatric hospital were examined. We aimed to pay attention to the comorbidity in the psychiatric inpatients. Method: Patients hospitalized to psychiatry services of the mental hospital between January 2007 and December 2009 were enrolled in the study. With this object in mind, we screened 6334 consultation request recorded in our hospital's automation system. Age, gender, inpatient psychiatry clinic, number of hospitalized days, specialty from which a consultation is required and the discharge diagnostics of the patients were investigated. Results: Although the number of hospitalized patients has decreased the power of the study, size of the case number increased it. The evaluation of the diagnosis based on the requested specialties revealed that 23.7% of the cases were requested from neurology. It was followed by respiratory system diseases (15.5%), musculoskeletal system diseases (14.4%), endocrine and metabolic diseases (13.3%) and cardiovascular diseases (11.3%) respectively. Conclusion: Comorbid diseases will exacerbate the clinical manifestation of the psychiatric diseases and on the other hand this will increase the severity of the existing medical condition. Therefore, general medical condition of the psychiatric patients must not be neglected. It is obvious that psychiatrists should update their general medical knowledge in this respect. [ABSTRACT FROM AUTHOR]

Purpose: Despite some data on neurological comorbidities in general hospitals, emergency rooms or intensive care units no previous study, to our knowledge, regarding neurological consultations in respiratory diseases hospitals has been performed yet. In this study, it has been aimed to question the value and benefit of neurological consultations for a respiratory disease hospital. Methods: This study was performed in a respiratory diseases and thorax surgery education and research hospital in Istanbul, Turkey in the first quarter of 2012. We evaluated the characteristics of neurological consultations and diagnoses. Patients who were consulted by the same neurologist in 3 consecutive months were included in the study. A form questioning demographics and clinical details of the consultation was filled in for each patient. Results have been analyzed with student t-test and chi-square analysis. Findings: During 3 months, 116 patients were consulted to neurology. The prevalence of neurology consultations was 2%. Oncology clinic followed by respiratory intensive care unit asked consultations the most frequently (42.3% and 40.9%). Agitation was the most frequent reason for neurology consultations (13%). The most common diagnoses made by the neurologist in all patients were stroke and dementia (12% each). Delirium (25%) was the most common diagnosis for the symptoms which started after hospitalization. Discussion: Neurology consultation frequency in a respiratory diseases hospital was not different from general hospitals. The neurologist has been consulted for a vast spectrum of symptoms which are neurologic, neurologically related or non-neurologic. Conclusion: A neurologist is necessary for all branch hospitals. Rational consultation demands will increase the benefit from consultation process. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine general characteristics of patients who presented to emergency service (ES) of our hospital (OH) and required internal medicine (IM) consultations. Materials and Methods: We evaluated patients aged 18 years and older, who presented to the ES of between Nov 01,2010 and Dec 31,2010 and who were referred for IM consultations. Results: A total 7100 patients were admitted to ES of during this study period and 546(7,7%) patients were referred for IM consultation. The mean age of the study patients was 60,13±18,10(62; 18-97) and 54,4%(297) of the patients were female. Among the most common causes for the study patients, to present to ES were symptoms related to the gastrointestinal system (31,3%-171) such as abdominal pain, nausea-vomiting, hematemesis or hematochezia and the most frequently observed consultation was IM consultation depending on nephrological causes (34,2%-187) such as high BUN and creatinine levels, and electrolyte imbalance. In addition to the routine examinations such as blood count, biochemical tests, electrocardiography, P-A Chest graphy, urinalysis, 444 patients(81,3%) were referred for further examinations involving either blood or screening methods. In conclusion, 50,4% of the patients were discahrged, 4.6% died in the ES and 45% were hospitalized. Coclusion: Determining patient profiles in ES, for whom IM consultations were requested, will contribute to the curriculum of the relevant training programs aiming to train staff in this particular field of medicine and thereby the quality of health care srevices. [ABSTRACT FROM AUTHOR]

Objective: There are some suggestions regarding the methods of consultation practice in the literature including which case will be consulted, to whom, by which transport means, the payment methods as well as the ethical issues. There are no standards for consultations in Turkey. The standardization committee of the Federation of Turkish Pathology Societies has conducted a survey to detect the current situation, determine the problematic aspects, compare the situation with international methods and offer methods specific to Turkey. Material and Method: A survey has been prepared to cover all the aspects of consultation practice using the literature and referring to the current methods used in Turkey. The survey has been announced on the internet and 83 replies were collected. Results: Multiple choice questions were evaluated in terms of percentages and open ended questions were grouped according to the answer contents. It was seen that problems could be grouped as follows: absence of written procedures covering each step, means of transport, reaching the consultant, payment, reporting and ethical issues. The absence of procedures and issues regarding the payment methods were the interfering factors for each step of consultation. Conclusion: There are many problematic issues in consultation practice in pathology in Turkey. The basis of these problems is the absence of written regulations for procedural and payment methods. Regulations addressing these issues should be developed. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to investigate the various features of infectious disease consultations, antibiotic usage before and after consultations and adherence to the recommendations of the infectious disease physicians in hospitalized elderly patients. Materials and Method: This retrospective study was conducted in Zonguldak Karaelmas University Teaching and Research Hospital. Hospitalized patients aged 65 years and over for whom an infectious disease consultation was requested between January 2010 and January 2011 were included in the study. Results: The most common causes of consultation requests were the presence of high fever alone, leukocytosis alone, infiltration on chest X-ray, and skin and soft tissue infections. The most commonly diagnosed infections by the infectious disease physicians were community-acquired pneumonias, nosocomial pneumonias and urinary tract infections. In 99 patients, empirical antimicrobial therapy was initiated prior to the infectious disease consultation request, and the most commonly used antibiotics were third-generation cephalosporins and ciprofloxacin ± ampicillin-sulbactam. The most common antimicrobial regimens initiated after the consultation were carbapenems, piperacillin-tazobactam and cefoperazone-sulbactam. The mortality rate of the patients in whom the initiated antibiotic treatment regimens were broadened was significantly higher than the mortality rate of the patients in whom the treatment regimens were not changed and in patients whose treatment was initiated by the infectious disease physicians. Adherence to the recommendations was complete in 292 of 303 consultations. Conclusion: The empirical treatment of hospitalized elderly patients may include broader spectrum antibiotics. Adherence to the recommendations of the infectious disease team may help solve serious and complex infectious problems. [ABSTRACT FROM AUTHOR]

Objective: We aimed to evaluate the demographic and clinical features of patients who attended the emergency department of Uludag University Hospital, our emergency practices and the deficiencies. Materials and Methods: All adults and trauma patients under 18 years were included in this prospective study. The evaluations were done with the study forms including patient data recorded by the doctors and nurses. Results: The mean age was 42.00±20.8 years, most (37,5%) comprised young adults (20-39). Only 10.1% of patient transfer to hospital was by ambulance. Most attendences were between 12: 00-16: 00 hours. 19.6% of the patients were categorized as Triage 1, signifying the very urgent group. were Evaluation by the physician of 76.4% of the patients was made in the first 5 minutes of attendance. Consultations were required in 39.1% of the patients, mostly from internal medicine, cardiology and orthopedics. Of the patients,12.2% were hospitalized and 4.5% were referred to another hospital. Patients were most frequently admitted to internal medicine, plastic surgery and cardiology clinics. Besides radiography, radiologic investigations were needed ın 12.6% of patients and Cranial Computed Tomography was the most frequently required. The average length of stay was 143.1 minutes for all patients, but this was 585.1 minutes for patients needing hospitalization. Conclusion: It was determined that the lengıh of stay of patients admitted to the hospital is longer than expected. Although there are deficiencies which must be ameliorated, it was concluded that the emergency department of Uludag University Hospital is adequate for a 3rd step emergency. [ABSTRACT FROM AUTHOR]

Objectives: We investigated nosocomial infections diagnosed via consultations with the Department of Infectious Diseases and Clinical Microbiology at Reanimation I-II intensive care units. Patients and Methods: Of 3750 patients hospitalized at Reanimation I-II intensive care units, 1221 patients were followed up via consultations with the Department of Infectious Diseases and Clinical Microbiology. Additionally, main diseases that require intensive care, other concomitant diseases, demographical data, hospital stays and isolated microorganisms were evaluated. Results: Seven hundred and fifty-six patients (61.9%) were diagnosed with nosocomial infections according to the criteria of Centers for Disease Control and Prevention. Among these infections, nosocomial pneumonia took the first place. As infectious agent, Pseudomonas spp. (19.7%) took the first place, followed by Acinetobacter spp. (17.3%) and Staphylococcus spp. (16.7%). Conclusion: Nosocomial infections are common at intensive care units. Besides infection control precautions, consultations with Infectious Diseases are also important in quick identification and treatment of these infections. [ABSTRACT FROM AUTHOR]

Objective: Evaluation was made of the consultation results of patients who were thought to need a surgical approach and consulted the Chest Surgery Department for diagnostic support and treatment offers after detection of a clinical and/or radiological pathology of the respiratory system. Material and Method: In our hospital, one hundred and eighty eight patients who were evaluated by our clinic between 2006 an 2008 were analyzed prospectively. Of the cases, 247 were male (63.65%), 141 were female (36.35%) and mean age was 49±9,1. During the consultations, the detailed histories of the patients including the symptomatology related to the age, gender and respiratory system were recorded. Physical examinations and laboratory assays were performed. Results: It was noticed that the Emergency Medical Department was the departments which r most frequently required consultations from the Chest Surgery Department (50.51%). Of the Internal Medicine branches, the Chest Diseases Department (14.43%); and of the Surgical branches, the General Surgery Department were those which required the most consultations from our department. Chest X-ray and thorax tomographies of the patients consulted in the Emergency Medicine Department revealed mostly rib fracture (36.34%) and lung contusion (14.43%),while atelectasis (22.91%), mass/nodule (20.31) and pleural effusion (15.10%) were most common in patients from other departments. Conclusion: It is important to employ adequate expert health staff in emergency medicine departments in order to prevent time consuming, unnecessary consultations and reduce health expenditures. The contribution of the Chest Surgery Department in the diagnosis and planning of treatment of lung and pleural pathologies should not be overlooked. It might be helpful to educate the health staff about postoperative patient care for the prevention of respiratory complications which may develop postoperatively in surgical branches. [ABSTRACT FROM AUTHOR]

Attention Deficit Hyperactivity Disorder is one of the most common developmental disorders of childhood with a reported world-wide prevalence of 8 to 12%. In studies conducted in our country the prevalence rates in community were reported to vary between 8.6 to 8.1 % while clinical prevalence rates were reported to vary between 8.6 to 29.44 %. Fifty to eighty percent of cases were reported to continue into adolescence while thirty to fifty percent may continue into adulthood. Attention deficit hyperactivity disorder is known to accompany subtle physical anomalies, allergic and neurologic disorders, obesity and eating disorders, traumatic injuries, risky sexual behavior, sleep disorders, substance and alcohol use, axis I and II disorders, occupational, legal and academic problems and increased treatment expenditures. Though the effects of this disorder continue throughout life, create burdens to the society along with its treatment as well as disabling the affected patients through their lives, and receive increasing attention in recent years, reviews focusing on problems associated with it are lacking. Therefore, this study aimed to summarize the results of previous studies conducted about medical comorbidities in attention deficit hyperactivity disorder. [ABSTRACT FROM AUTHOR]

Giriş: Meningoensefalit; beyni çevreleyen zarların ve beyin dokusunun enfeksiyonlarını içeren bir tanımdır. Hızlı tanı konup hızlı tedavi başlanması gereken, ciddi mortalite ve morbiditeye sebep olabilen en önemli enfeksiyon acillerinden biridir. Bu hasta grubu şiddetli belirtiler nedeniyle büyük çoğunlukla acil servislere başvurmakta ve acilde değerlendirilmektedir. Bu çalışmamızdaki amacımız acil servisten istenen meningoensefalit ön tanılı konsültasyonların ne kadar sağlıklı olduğu, acil servis hekimlerinin hangi bulguları mevcut olan hastalarda meningoensefalit konsültasyonu istediği, danışılan hastaların kaçında meningoensefalit tanısı konduğu, lomber ponksiyonların ne kadarının gereksiz yapıldığı gibi birçok soruya cevap aramaktır. Gereç ve Yöntem: Çalışmamızda 01.04.2020-01.04.2022 tarihleri arasında Dicle Üniversitesi Tıp Fakültesi Hastanesi Acil Servisi’ne başvuran ve enfeksiyon hastalıkları kliniğine meningoensefalit ön tanısı ile konsülte edilen hastalar retrospektif olarak değerlendirildi. On sekiz yaşından küçük olmak, beyin cerrahi operasyonu geçirmiş olmak, şant mevcudiyeti çalışma dışı bırakma kriterleri olarak belirlendi. Geri kalan hastalar değerlendirilmeye alındı. Kriterlere uyan 197 hasta tespit edilerek değerlendirildi. Bulgular: Çalışmaya alınan 197 hastanın 91’i kadın (%46,2) 106’sı erkek (%53,8) idi. Yaş ortalaması 52,4±26,66 idi. Semptomların sıklığı, şuur bulanıklığı: 130 (%66), baş ağrısı: 118 (%59,9), ateş: 71 (%36), bulantı ve kusma: 47 (%23,9), ense sertliği: 41 (%20,8) hastada saptandı. Hastaların 153’üne (%77,7) acil serviste lomber ponksiyon yapılmış 44’üne (%22,3) ise yapılmamıştır. Yüz doksan yedi hastanın 44’ünde (%22,3) meningoensefalit tanısı konmuş olup 153’ünde (%77,7) ise meningoensefalit dışlanmıştır. Meningoensefalit tanısı konan 44 hastanın 23’ü (%52,3) bakteriyel, 9’u (%20,5) viral, 7’si (%15,9) viral-bakteriyel ayırımı yapılamayan, 3’ü (%6,8) tüberküloz (TBC), 2’si Brucella meningoensefaliti olarak değerlendirilmiştir. Meningoensefalit tanısı konan 44 hastanın 15’inde (%34,1) kültür veya PCR ile etken tespit edilebilmiştir. Bu 15 etkenin 6’sı S. pneumonia, 4’ü HSV-1, 2’si M. tuberculosis, 2’si Brucella spp. ve 1’i E. coli olarak tespit edilmiştir. Sonuç: İki yıllık süre zarfında enfeksiyon hastalıkları kliniğine acil servisten meningoensefalit ön tanısı ile danışılan 197 hastanın 153’üne lomber ponksiyon yapılmıştır. Danışılan 197 hastadan, 44 hastaya meningoensefalit tanısı konmuştur. Bu oran danışılan hastaların sadece %22,3’ü olup geri kalan hastalarda meningoensefalit dışlanmıştır. Bu sebeple acil serviste hastalar meningoensefalit semptomları açısından daha dikkatli değerlendirilmeli ve gerekirse enfeksiyon hekimleri tarafından acil servis hekimlerine düzenli aralıklarla meningoensefalit konusunda eğitici seminerler verilmeli ve bilgileri güncellenerek gereksiz lomber ponksiyon sayısının minimuma indirilmesi ve olası komplikasyonların önlenmesi sağlanmalıdır. [ABSTRACT FROM AUTHOR]

Amaç: Romatizmal hastalıkların multisistemik seyrinden dolayı bu hastalıklara sahip olgular hastanelerin farklı bölümlerinde yatabilmekte ve konsültasyon kaçınılmaz olmaktadır. Bu çalışma ile hastanemizde yatan hastalarda romatoloji konsültasyonlarının nedenleri, gerekliliği ve hekimlerin romatolojik hastalıklar konusunda bilgisini değerlendirmeyi amaçladık. Yöntem: Şubat 2015-Ocak 2017 tarihlerinde Ege Üniversitesi Tıp Fakültesi Hastanesi Romatoloji bölümüne danışılan 1071 konsültasyon çalışmaya dahil edildi. Olgular romatolojik hastalığa sahip olanlar ve olmayanlar (sırasıyla Grup 1 ve Grup 2) olarak incelendi. Konsülte eden bölümlerin dağılımlarına bakıldı. Grup l'de konsültasyon gerekçeleri perioperatif değerlendirme, tedavi rejiminin değerlendirilmesi, ikinci bir patolojinin romatizmal hastalık ile ilişkisinin değerlendirilmesi ve diğer nedenler olmak üzere dört alt başlıkta incelendi. Grup 2'de yeni tanı romatizmal hastalıklar (YTRH) kaydedildi. Bulgulan Toplam 1071 konsültasyonda 770 farklı hasta değerlendirildi. Hastaların 466'ı kadın ve 304'ü erkek olup, ortalama yaş 52.3 idi. Grup l'de yer alan 374 (%48.6) hastadan %44.65 ile en sık konsültasyon gerekçesi tedavi rejimininin düzenlenmesi (en fazla Göğüs Hastalıkları bölümü) olup sırasıyla %41.44 perioperatif değerlendirme (%57.1'i Ortopedi bölümünden romatoid artrit hastalarında total kalça veya diz protezi amacıyla), %9.89 diğer nedenler ve %4.89 romatolojik hastalığın ikinci bir patoloji ile ilişkisinin değerlendirilmesi olarak saptandı. Romatoid artrit (RA), Behçet Hastalığı (BH) ve Siste-mik Lupus Eritematozus (SLE) grup 1 içerisindeki hastaların en sık sahip oldukları romatolojik patolojilerdi. Grup 2'de ise 396 hasta (%51.4) mevcut olup, 68'inde (% 17.2) YTRH saptandı. En fazla saptanan YTRH ise 11 olgu ile SLE ve ANCA ilişkili vaskülit (AAV) idi (Şekil 1 PS-65). Konsültasyon sonucunda en yüksek YTRH saptanan klinikler dermatoloji: %26.1, kalp-damar cerrahisi: %25 ve göğüs hastalıkları: %22.9 bulundu (Şekil 2 PS-65). Sonuç: Romatizmal hastalıklara sahip bireylerde cerrahi prosedürler yatan hasta konsültasyonlarının ana gerekçelerinden birisidir. Grup 2'de düşük YTRH oranları farklı kinliklerdeki hekimler için romatizmal hastalıklar hakkmda yetersiz bilgilerinden kaynaklanabilir. YTRH arasında yüksek oranda SLE ve AAV saptanması çalışmanın üçüncü basamak bir hastanede yapılması ile ilişkilendirilmiştir. Çalışmamız romatoloji konsültas yonları ile ilişkili ülkemizde ilk çalışma olup bu konuda litera türde kısıdı veri bulunmaktadır. [ABSTRACT FROM AUTHOR]

Distinct from children, adolescents can understand the abstract meanings of illness and death. Besides what they have to achieve developmentally, they have to handle the burden of the illness and the treatment process. They may fail to obtain the expected independence and the physical aspects, which are very important to them in building intimate relationships, may worsen. Because acute treatment of psychiatric problems is crucial to prevent the chronic consequences, the psychiatric consultant should be a member of the medical team. Post traumatic stress disorder and major depression are the most commonly seen psychiatric disorders in adolescents with chronic illness. Although pharmacotherapy and cognitive behavioral therapy are used in treatment, there are no controlled studies proving the efficacy of these treatments in this population. [ABSTRACT FROM AUTHOR]