Background/aim: Analysis of interventions for special patient groups is important for the planning of health services, especially emergency medical services. In this study, we aimed to evaluate emergency medical service (EMS) interventions for the elderly and determine the decisive factors affecting transfer to the hospital of EMS team, over two years (2017)(2018) in İzmir. Materials and methods:Records of 112 emergency calls that were made between 2017 and 2018 followed up with interventions for patients aged 65 years and older were obtained from the 112 system. The reasons for the calls, outcomes, possible diagnoses of the patients, differences in time intervals and seasons, characteristics of the patients transferred to the hospital, and factors affecting the need for transfer to the hospital were investigated.Results: A total of 176,104 elderly patients with a mean age of 78.02 ± 8.0 years required ambulance services, and out of them, 66% were transferred to the hospital. Transfer to the hospital was significantly associated with the event location, gender, time interval, international classification of diseases (ICD) codes, and physical examination findings. Conclusion:Ambulance interventions are more frequently required in urban areas than in the countryside, and calls are mostly made in the daytime hours and during winter months.The decision to transfer a patient to the hospital is based on the patient's respiratory status, skin examination, state of consciousness, pulse, systolic blood pressure, call time, and the preliminary diagnosis of the crew.

In this report, we tried to discuss the pathologic mechanisms of abdominal pain and describe correct modalities of diagnosis by defining clinical findings and symptoms of patients admitted with abdominal pain.Evaluating abdominal pain requires an approach that relies on the probability of disease, patient history, physical examination, laboratory tests, and imaging studies. The location of pain is a useful starting point and will guide further evaluation.

Dislocations of the atlantooccipital junction are rarely encountered fatal injuries, and occur with high energy traumas. Although atlantoaxial rotational instabilities are mostly seen after upper respiratory tract infections in children, trauma and congenital causes should be considered as possible conditions.. Atlas fractures comprise 10% of all cervical and 25% of upper cervical injuries. While posterior arch fractures are the most frequently encountered among atlas fractures, Jefferson fractures and burst fractures are less common and the rare type is massa lateralis fractures. Atlantoaxial instability (AAI) and, less often occipitoatlantal instability (OAI) is a part of the spectrum of Down syndrome. As a very important issue, cervical trauma patients presenting to the emergency department should be carefully treated to prevent mortality and morbidity is very important. Computed Tomography is sufficient for diagnosis in suspected cases of cervical fracture and dislocation. However, MRI imaging may be required in conditions of ligament damage and spinal cord compression. In our case with Down Syndrome; the patient had tactile sensitivity on the spinous process on cervical examination. Immoblization was achieved with a collar. In computed tomography, post-traumatic fracture of the C1 vertebral arch was considered. In Down Syndrome, although history, clinical examination and imaging are evaluated as the presence of a C1 fracture, atlantoaxial instability and cervical dysmorphology should be kept in mind in Down syndrome. In these cases, AAI should be ruled out by radiological imaging methods. The most important part of the treatment is making a correct diagnosis. The deterioration of the neurological picture and new pathologies that may be caused by cardiovascular system or respiratory system failures should be prevented.

INTRODUCTION: Head trauma is the most common cause of traumatic death between the ages 1 and 44 and especially among 15-24 year- old males. Most frequent causes of head trauma are car accidents, sports injuries, work accidents, assaults, and terrorism. When classification is based on Glasgow Coma Scale head injuries are divided into 3 groups as minimal-minor, mild and severe head traumas. The most important points in the early diagnosis, and treatment of the patient with head trauma are detailed anamnesis, physical, neurological, and radiological examination.Diagnostic evaluation of patients with head trauma has been a great problem for physicians for years. Introduction of brain CT into medical practice has created revolution in this field. Brain CT is a diagnostic tool for the evaluation of traumatic brain injuries, because it has a rapid acquisition time, it is universally available, easy to interpret, and reliable. METHODS: The cases brought to the Emergency Medicine Clinic due to head trauma and underwent brain CT in June 2015 were included in our study. The data of the patients were evaluated retrospectively. For this purpose, emergency service files, hospitalization files and records entered into the hospital automation system with ICD-10 codes were analyzed. RESULTS: A total of 353 patients with head trauma applied to our emergency department between the specified dates, and 177 of these patients had undergone brain CT. The female/male ratio of these patients was 40/64 and the most common application was in the 18-59 age group. According to the brain CT results, 89 patients did not have any pathological findings, while indicated number of patients had atrophy (n=8), intracranial hemorrhage (n=2), contusion (n=2), subdural hematoma (n=1), hydrocephalus (n=1) and chronic ischemia (n=1). DISCUSSION AND CONCLUSION: In this study, the benefit of using online technology in interpreting tomography of patients who admitted to emergency department with head trauma and underwent brain CT during off-hours was emphasized.

BACKGROUND:The most frequent etiologic cause is alkaline substances. We investigated the protective effects of the plant St. John 's Wort (Hypericum perforatum).