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Introduction: Otolaryngologists are required to possess the knowledge, skills, and confidence necessary to manage consultations requested by palliative care services. However, the inclusion of palliative care needs in otolaryngology residency training is limited. The goal of this study was to enhance awareness of otolaryngologists' palliative care knowledge and skills by evaluating otolaryngology consultations requested by tertiary palliative care services between 2016 and 2021.Methods: This retrospective cross-sectional study included patients who consulted the otolaryngology department from the palliative care service of Kutahya Health Sciences University between January 1, 2016 and September 31, 2021. A total of 80 otolaryngology consultations were requested between 2016 and 2021. Patients were evaluated for age, gender, diagnosis of palliative admission, reason for consultation, date of consultation, interventions, and additional investigations.Results: There were 27 female patients (33.7%) and 53 male patients (66.2%). The mean age was 65.0 (range: 22-97) years. It was found that the volume of consultations did not increase significantly over a five-year period (p=0.502) and 78.8 % of consultations were requested during working hours (08:00-16:00). In addition, the response time (minutes) for consultations during working hours (08:00-16:00) was significantly lower than outside working hours (16:01-07:59) (p lt;0.001). The reasons for requesting a consultation and the procedures performed were significantly different between patients under and over 65 years of age (p=0.019 and p=0.008, respectively).Conclusions: This is the first study to evaluate otolaryngology consultations requested by a tertiary palliative care service. Awareness of these consultations may provide guidance for the assessment and management of patients in palliative care services.Keywords: consultation, otolaryngology, tracheotomy, palliative care

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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: The aim of this study is to evaluate the clinical, demographic, and diagnostic characteristics of pediatric patients consulting the dermatology department. Methods: Patients who were consulted to the dermatology department from pediatric clinic of XX 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, with a median age of 5.5 years (1.5-10.5 ) were evaluated. The outpatient clinic were seen to have made the most requests for consultation. The most frequent complaints on presentation were seen to be 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 pediatric patients and can reduce economic costs.

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Bu çalışma, bir devlet hastanesi acil servisinden Göğüs Hastalıkları bölümüne istenen konsültasyonların genel klinik özelliklerini ve konsültasyon istenme nedenlerini ortaya koymak amacıyla tasarlandı. Gereç ve yöntem: Çalışmaya 1 Ocak 2018-31 Aralık 2018 tarihleri arasında Kastamonu Devlet Hastanesi Acil Servisi'ne başvuran ve göğüs hastalıkları konsültasyonu(GHK) istenen hastalar dahil edildi. Hastaların sosyodemografik verileri, başvuru şikayetleri, hastaneye geliş şekilleri, evde cihaz kullanımı durumları, konsültan hekimin konsültasyona cevap verme süresi, konsültasyon olan ön tanısı, konsültasyon sonrası aldığı son tanı, radyolojik bulguları veri toplama formuna kaydedildi. Kendi isteğiyle hastaneden ayrılan, dosya bilgileri eksik olan ve konsültasyon istenmesine rağmen herhangi bir nedenle göğüs hastalıkları uzmanı tarafından değerlendirilmeyen hastalar çalışma dışı bırakıldı. Bulgular: Çalışmaya ortalama yaşı 72,8±14,4 olan, 280(%53,9) erkek, 239(%46,1) kadın hasta çalışmaya dahil edildi. En sık eşlik eden hastalıkları kardiyovasküler hastalıklar iken, en sık başvuru nedeni nefes darlığı idi. En sık pnömoni, kronik obstruktif akciğer hastalığı alevlenmesi ve pulmoner emboli nedeniyle GHK istenmişti. Göğüs hastalıkları uzmanlarının acilden istenen konsültasyonları yanıtlama süresi 93,8±127,3 (1-837) dakika olarak tespit edildi. En sık saptanan radyolojik anormallik infiltrasyondu. Acil servisten istenen konsültasyonların %20(104) terminal dönem hastalardan oluşmaktaydı Sonuç: Acil servislerden istenen GHK önemli bir kısmının ileri yaşta, bakıma muhtaç hastalardan oluştuğu gözlemlendi. En sık hastaneye yatış nedeninin pnömoni olduğu sonucuna varıldı.

Amaç: Biz çalışmamızda 2019 yılı içerisinde ayaktan başvuran ya da yatarak tedavi gören hastalardan istenen psikiyatri konsültasyonlarına ait verileri geriye dönük olarak incelemeyi amaçladık. Gereç ve Yöntem: Hastanemizde yatarak tedavi gören veya acil servise ayaktan başvuran, psikiyatri konsültasyonu istenen 18 yaş ve üstü hastaların verileri, hastane kayıt sistemi üzerinden incelenmiştir. Bulgular: Toplamda 961 hastaya psikiyatri konsültasyonu istenmiştir. Hastaların 511’i (%53.2) kadın, 450’si (% 46.8) erkeklerden oluşuyordu. Kadınların yaş ortalaması 53.65±21.5 yıl, erkeklerin ise 57.59±21.38 yıl idi. Bunlardan 23 (%2.4) kişi acil servise ayaktan başvuran, 204 (%21.2) kişi yoğun bakım ünitesinde (YBÜ), 280 (%29.1) kişi cerrahi servislerde, 454 (% 47.3) kişi ise dahili servislerde yatarak tedavi gören hastalardı. Diyabet (DM), hipertansiyon (HT) gibi endokrinolojik hastalıklar (n=228, % 23.7), KOAH (kronik obstruktif akciğer hastalığı), astım gibi göğüs hastalıkları ile ilgili hastalıklar (n=165, %17.2) en sık eşlik eden fiziksel hastalıklardı. Psikiyatrik tanıları ise; anksiyete bozukluğu 409 (%42.6), depresif bozukluk 131 (%13.6), uyum bozukluğu 70 (%7.3) kişi ile en sık konulan tanılar idi. Öz kıyım girişiminde bulunan hastalar 123 (% 12.8) kişi idi. Hastalardan 71 (%57.73)’i kadın, 52 (%42.27)’si erkekti. Hastaların yaş ortalaması 30.64±5.64 idi. Depresif bozukluk ve anksiyete bozukluğu en sık konulan tanılardı. Sonuç: Psikiyatri dışı kliniklerde değerlendirilen hastaların tanı ve tedavilerinin psikiyatri hekimiyle işbirliği içinde düzenlenmesi tedaviye uyum ve hastalığın prognozu açısından önemlidir. Bu çalışma Elazığ ili psikiyatri konsültasyonlarını inceleyen ilk çalışmadır. Bu çalışma ile diğer illerde yapılan çalışmaların karşılaştırılması ve psikiyatrik yaklaşımlara yön vermesi amaçlanmaktadır.

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]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pamukkale Medical Journal is the property of Pamukkale Journal of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Amaç: Çocukluk çağındaki deri lezyonları, deri hastalığı nedenli veya diğer hastalıklara bağlı olabilir. Lezyonların tanısı, erken ve etkin tedavisi için önemlidir. Bu çalışmanın amacı dermatoloji kliniğine tanı ya da tedavi amacıyla danışılan çocuk hastalardaki deri lezyonlarının değerlendirilmesidir. Gereç ve Yöntem: Ocak 2014-Aralık 2017 tarihleri arasında çocuk sağlığı ve hastalıkları kliniğinden dermatoloji kliniğine yapılan konsültasyonlara ait hasta verileri retrospektif olarak tarandı. Verilerde eksiklik bulunmayan hastalar çalışmaya dahil edildi. Bulgular: Değerlendirmeye alınan 500 hastanın 226’sı (%45,2) kız, 274’ü (%54,8) erkekti. Hastaların yaş aralığı bir gün ile 17 yıl arasında değişmekte olup, yaş ortalaması 5,14±4,7 yıl idi. Hastaların 425’i (%85) ayaktan başvuran poliklinik hastası, 75’i (%15) yatan hastaydı. Yüz otuz hastada (%26), klinikler arası tanı uyumu gözlenirken, 73 hastada (%14,6) kliniklerin tanıları farklıydı. Hastaların 297’sinin (%59,4) konsültasyon istem notunda tanı/öntanı yoktu. En sık danışılan hastalıklar sıklık sırasına göre, ekzemalar, enfeksiyonlar, böcek ısırığı reaksiyonları, kserosis kutis (deri kuruluğu) ve tırnak hastalıklarıydı. Sonuç: Jeneralize döküntü ile seyreden hastalıklar ve ekzemaların ayırıcı tanısı ve tedavisine yönelik bilgi düzeyi artırılmalıdır. Böcek ısırıkları hem lokalize hem de jeneralize döküntülerin ayırıcı tanısında düşünülmelidir.

Copyright of Yeni Üroloji Dergisi is the property of Ali Ihsan Tasci and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

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]

Copyright of Journal of Surgery & Medicine (JOSAM) is the property of Journal of Surgery & Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

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]

Amaç: Bu çalışmada, bir eğitim ve araştırma hastanesinde 6 aylık süreçte çocuk ve ergen yaş grubu için istenen çocuk psikiyatri konsültasyonlarının değerlendirilmesi amaçlanmıştır.Yöntem: 1 Temmuz 2010- 31 Aralık 2010 tarihleri arasında Konya Eğitim ve Araştırma Hastanesi'nde yatarak tedavi gören çocuk ve ergen hastalar için istenen konsültasyonlar geriye dönük olarak incelenmiştir. Konsültasyonların hangi birimlerden istendiği, çocuklardaki ruhsal ve bedensel hastalık tanıları, psikiyatrik tedavi ve izlem sürecine ilişkin veriler değerlendirilmiştir.Bulgular: Bir yıllık sürede yatarak tedavi gören çocuk ve ergenlerin 57'si (%1.5) için psikiyatri konsültasyonu istenmiştir. Konsültasyon istenenlerin %70.1'i kızdır ve %63.1'i 12 yaş veya üzeri yaştadır Olguların %86'sında en az bir psikiyatrik bozukluk saptanmış olup en sık konulan tanı 'anksiyete bozukluğu' dur (%33.3). Olguların %70.2'sine psikotrop ilaç başlanmıştır ve erkekler ile kızların psikotrop ilaç kullanım oranları benzer bulunmuştur. Konsültasyon sonucunda ayaktan çocuk psikiyatrisi izlemi önerilen 37 olgunun 14'ü (%37.8) ayaktan tedaviyi sürdürmüştür.Sonuç: Bu çalışmada konsültasyon istenen olgularda yüksek psikopatoloji saptanmış olmakla birlikte, konsültasyon istenme oranlarının düşük olduğu görülmüştür. Çocuk hastalıklarıyla uğraşan hekimlerle, ruh sağlığı uzmanlarının birlikte çalışmalarının konsültasyon sürecinin sağlıklı işlemesi açısından önemli olduğu düşünülmüştür.

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]

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]

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: 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]

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]

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]