Journal of Medical and Surgical Research

6

Authors: Murat Saritemur

Introduction: Leaving against medical advice is a worrying situation which is a problem not only for patients also for physicians. For many different reasons, people may choose to leave the hospital on their own requests. If we know the reasons for leaving, we can find the solution. Method: This prospective study was conducted at an emergency department of a university hospital that is visited by more than 30.000 patients annually. Demographic characteristics such as sex and age, triage level, insurance status of the patients, length of stay in the emergency department and why they were leaving against medical advice were recorded. Results: A total of 321 patients which constituted 1.1% of all admissions to the emergency department during the study period left against medical advice. The main reason was refusing the observation or hospitalization (34.6%; n=111) and the second reason was inadequate health insurance (19.6%; n=63) in all study population (Table 1). Although inadequate health insurance was the second reason in males (36 of 153 patients; 24.0%), the second reason was refusing the intervention or medication in females (52 of 168 patients; 31.1%). The patients who left due to dissatisfaction with health care were predominantly male (72.7%; n=24; p=0.002) whereas who left due to refusing the intervention or medication were predominantly female (88.9%; n=48; p<0.001). Conclusion: Hospitals should endeavor to identify the reasons why patients leave the ED, to document the events in detail and also to solve the problem.

8

Authors: S. Housbane

In recent years, medical informatics has played an integral role in medicine, biology, and public health. The emergence of medical informatics as a discipline is largely due to advances in information technology, and an increasing awareness that biomedical knowledge about patients are essentially unmanageable by traditional paper-based methods. This study aims to develop a web application to assist endocrinologists in standard therapeutic protocols used in clinical and therapeutic aspects of endocrinology and drugs, and to contribute to a better management of drugs, and patient management recommendations. We outline key concepts as well as the application development stages of the application. The development of the application consists of defining needs, objectives and target audience, locating stakeholders and identifying their roles, modeling, choosing the most appropriate technology tools to reach the maximum targets, and finally developing the application. Endocrinology Prescription Support Application (EPSA) was developed for better information diffusion and communication within the endocrinology community. The application is enhanced by dynamic documents using small interactive scripts (JavaScript), e. g. Body Mass Index (BMI) calculation and interpretation. The use of these systems and their success rely on medical informatics which establishes connection and communication between computer scientists and endocrinologists to develop better integrated systems in their daily practice.

3

Authors: Özlem Bilir

Tea is a drink widely consumed all over the world. Tea growing is the most important source of income in the Eastern Black Sea region of Turkey. After many years of being harvested by hand, tea began being harvested by machine, giving rise to an increase in accidents involving the extremities. A retrospective investigation of 14 patients attending our university hospital due to tea-cutting machine accidents between January and December 2011 showed an age distribution of 19 to 71, and that 78.6% were male. The greatest number of cases was determined in September. Left lower extremities were frequently injured as a result of trauma (71.4%), with broken bones and severed tendons being observed in four of these (28.6%). While agricultural machines used in the harvesting and pruning back of tea raise the speed of production, they also lead to a rise in agricultural accidents. This study was intended to determine the severe injuries which such machinery can cause.

5

Authors: Frederic D. McKenzie

Fifty years ago computer science was just beginning to see common acceptance as a growing discipline and very few universities had a computer science department although other departments were utilizing computers and software to enhance their methodologies. We believe modeling and simulation (M&S) is on a similar path. Many other disciplines utilize M&S to enhance their methodologies but we also believe that M&S fundamentals can be essential in making better decisions by utilizing the appropriate model for the problem at hand, expanding the solution space through simulation, and understanding it through visualization and proper analyses. After our students learn these fundamentals, we offer the opportunity to apply them to varied application areas. One such application area is medical M&S, which is a broad area involving anatomical modeling, planning and training simulations, image-guided procedures and more. In this paper, we share several research projects involving M&S and the collaborations that make them possible.