An evaluation of traumatic deaths associated with animal attacks: A 10-year autopsy study.

BACKGROUND: Just as throughout the world in general, deaths related to animal attacks continue to be a public health problem in Turkey. A decrease in areas of natural habitat because of human invasion, and the use of these areas for hunting, wood-cutting, recreational and sporting activities has increased the possibility of humans encountering wild animals. METHODS: A physical retrospective screening was made of the forensic records of a total of 8944 autopsy cases in the Forensic Medicine Institute of the Trabzon Group Directorate in the 10-year period between Januarry 2007 and December 2016. RESULTS: When the types of animals causing the traumatic death were examined, the most frequent was cattle in 15 cases followed by horses in 7 cases, bears in 4 cases, wolves in 2 cases, and wild boars in 2 cases. According to the autopsy results, the cause of death was most often intrathoracic bleeding and intrathoracic organ damage, the regions of the body injured were seen to be most often the chest and back, and the most common form of injury was blunt/crush trauma. CONCLUSION: From these records, cases were identified where the cause of death was traumatic animal attack, and examination was made of the sociodemographic characteristics, the type of animal that caused the injuries, information about the location of the incident, witness statements, information about the healthcare centre, findings of external examination and autopsy, and the cause.

A medicolegal evaluation of geriatric cases with traumatic injuries.

BACKGROUND: The morbidity and mortality of traumatic injuries are higher in individuals aged >65 years, which are a population group showing an increase worldwide, compared to other age groups. The aim of this study was to compare the medicolegal aspects, such as abuse of the elderly with the morbidity and mortality rates of injuries resulting from trauma by examining the age, gender, trauma history, type of traumatic injury, clinical progress following injury, elderly abuse, and the care environment of the person in cases aged 65 years and older. METHODS: In this cross-sectional and descriptive study, a retrospective examination was made of the electronic and physical patient files of patients aged 65 years and older who presented at the Emergency Department of Blacksea Tecnical Univercity Medical Faculty Farabi Hospital between 2019 and 2020. RESULTS: Of the 647 patients who presented because of trauma, 384 (59.4%) were male and 263 (40.6%) were female. The leading cause of trauma was a same-level fall in 244 (37.7%) cases, followed by piercing or cutting injuries in 123 (19.0%), and a fall from height in 80 (12.4%) cases. Same-level falls and burns injuries were determined at a statistically significantly higher rate in females (p<0.001). CONCLUSION: Abuse of the elderly and the mechanisms of all traumas, primarily falls as the most common cause of geriatric trauma, are a subject that should be addressed in terms of forensic medicine. Preventative measures against trauma should be implemented and reviewed for the elderly, and health-care personnel should take responsibility for the legal reporting of forensic traumatic injuries.

Medicolegal evaluation in terms of physical abuse of children aged 0-3 years presenting at the emergency department with brain hemorrhage.

BACKGROUND: Physical abuse of children covers all types of non-accidental and preventable physical violence and injury perpetrated by the caregiver. METHODS: The study included children in the 0-3 years age group who presented at the Emergency Department (ED) with the finding of intracranial hemorrhage during the 5-year period of 2017-2021. These children were evaluated retrospectively, and findings that should be considered were revealed. RESULTS: In the 32 cases included in the study, the most common cranial finding was subdural hematoma, and the most common extracranial finding was ecchymoses. Presentation at the ED was seen to be 2 days after the trauma in 9.37% of the cases. CONCLUSION: Any physician who encounters findings related to physical abuse of a child must make a forensic and social services report. Physicians who do not make the necessary reports or act to the contrary have both a legal and moral responsibility in the subsequent process.

Evaluation of the fire-related deaths: Autopsy study.

BACKGROUND: The fire is a public health problem that occurs because of various reasons, threatens the lives of organisms, and may cause economic losses. The forensic investigation and the crime (event) scene investigation and first medical examination to be performed for the persons in the fire scene might reveal important evidences. METHODS: The autopsy reports prepared in Trabzon Branch Office, The Ministry of Justice Council of Forensic Medicine, for the death cases found in fire scene between 2007 and 2016 were retrospectively examined. RESULTS: As a result of analyzing the 10-year archive data, it was determined that 100 (63.3%) of 158 cases, which have been found in the fire scene and undergone forensic autopsy, were male and 58 (36.7%) were female. By excluding the group of cases with undetected origin, it was determined that there was a statistically significant difference between the homicide-caused deaths and the deaths with other causes (accident and suicide) in terms of the carboxyhemoglobin (HbCO) levels. By grouping the fire scene as outdoor and indoor areas, the comparison made between the HbCO levels of cases is presented in table. The difference between the two groups was found to be statistically significant (p<0.05). CONCLUSION: Starting from the crime scene investigation, a detailed radiological, toxicological, and pathological investigation must be performed for the persons taken out from the fire scenes. It was observed that the HbCO levels can be used in determining the space in which death occurred, the origin, and the comorbidities of the individual.

Medicolegal evaluation of cases with burn trauma: Accident or physical abuse.

INTRODUCTION AND OBJECTIVE: Burns are thermal injuries that may have a wide variety of clinical consequences from simple injuries to mortality. There are many aspects that must be medicolegally addressed in both non-survivors and survivors from burn injuries. The objective of this study was to determine sociodemographic characteristics, injury patterns, treatment requirements and prognoses of patients with burn injuries to evaluate the findings of neglect-abuse and forensic reporting processes. This study also aimed to contribute to the medicolegal classification criteria in respect of the factors that have an effect on the prognosis in the analyses. MATERIAL AND METHOD: The study was conducted by retrospective review of digital files and paper records of patients who received therapy in the Burns Unit of KTU Farabi Hospital between 1st January, 2013, and 31st December, 2017. RESULTS: Evaluation was made of a total of 1225 patients, comprising 769 (62.8%) males and 456 (37.2%) females, with a mean age of 21.8 ± 23.8 years (range, 1-89 years). The mean burnt body surface area was 14.29 ± 13.74. A trauma-related psychiatric disorder was diagnosed in 60 (4.9%) patients during treatment. When the medical history and physical examination findings were evaluated together, burn injuries suggested physical abuse in 54 patients (4.4%). The doctors who evaluated the patients with burn injuries in the emergency room and those who applied treatment in the Burns Unit made a forensic notification for 379 (30.9%) patients. The mean age of non-survivors was significantly higher than that of patients who survived to discharge (56.54 ± 28.60 years for non-survivors and 19.39 ± 23.12 years for survivors; p < 0.001). CONCLUSION: Burn injuries are frequently encountered, and they require precautionary measures. Burn injuries due to abuse are more frequently observed in the elderly and especially in children. Thus, the findings must be correctly interpreted, and more effort should be made to improve the knowledge of healthcare professionals about forensic reporting. Moreover, regulations should be implemented in respect of the medicolegal classification of trauma.

Evaluation of geriatric suicides in Turkey.

INTRODUCTION: Suicide is defined as an individual taking action towards themselves with the intention of terminating their own life. According to the World Health Organisation (WHO), 800,000 deaths per year worldwide are due to suicide. In 2012, suicide cases constituted 1.4% of all the deaths worldwide. In most countries throughout the world, the suicide rates of the elderly are higher than those of other age groups. Epidemiological studies have concluded that suicide rates increase with advancing age in all societies, this increase accelerates after the age of 65 years and the highest rates are reached after the age of 75 years. The aim of this study was to evaluate the demographic features, suicide methods and reasons for suicide in geriatric suicide cases between 2009 and 2013 using the data of the Turkish Statistics Institute (TUIK). MATERIAL AND METHODS: A retrospective evaluation was made of the TUIK data related to proven suicide cases aged 65 years and older in the 5-year period of 2009-2013. RESULTS: A total of 1723 geriatric suicides were determined in Turkey between 2009 and 2013. These comprised 1284 (74.5%) males and 439 (25.5%) females, showing a rate of males approximately 3 times higher than that of females. An increase of approximately 10% was seen in the deaths by suicide in 2013 compared to 2009. The highest rate of geriatric suicides within total geriatric deaths was observed to be in 2012 (15.2%) and the lowest rate was in 2010 (12.4%). The most common method of suicide in both genders was hanging. In the majority of cases of geriatric suicide of both genders, the reason could not be determined. In those cases where the reason was known, the most common reason was illness. CONCLUSION: It has been reported that the most significant factors in suicide prevention are friends and family. As there continues to be an extensive family structure and family connections are strong in Turkey, this can be considered to be one of the reasons for lower rates of geriatric suicide compared to other countries. As there is a strong adherence to Islam in Turkey, another significant reason for the low rate could be the effect of the belief that suicide is a sin in the Islamic religion.