[Clinical approach to foreign body aspirations in children and legal results]. / Çocuklarda yabanci cisim aspirasyonlarina klinik yaklasim ve hukuki sonuçlari.

Foreign body aspirations are a serious respiratory condition that can threaten life, particularly in childhood, in the first three years of life. In our article, the approach observed in physicians who face foreign body aspirations in the pediatric age group are analyzed and the approach proposed in these cases are discussed under the current literature and relevant legal regulations.

Risk factors for violence against women by intimate partners in Sakarya, Turkey.

OBJECTIVES: Intimate partner violence (IPV) is an important public health problem in many countries including Turkey, with serious short- and long-term physical and mental health consequences, as well as significant social and public health costs. To understand the violence characteristics and the individual risk factors for both the married women victims and the perpetrator partners are the objectives of this study. METHODOLOGY: 243 married women, who have consulted to hospitals and village clinics between 2008 and 2009 with the mean age of 36.76 (SD = 11.59), accepted to participate in the study voluntarily. Participants were divided into two groups as "victimized" (58.8%, n = 143) and "non-victimized" (41.2%, n = 100) women. Victimized group consisted of women who have had any type of violence from their husbands during their life. A 61-item questionnaire was prepared that included items on demographics, IPV experience, attitudes about IPV and knowledge of legal rights. RESULTS: As compared to non-victimized group, women in victimized group mostly lived in villages than in town/city centers, were illiterate, had bride-price agreement and were younger when married. Place of accommodation, age and number of pregnancies were associated with the risk of victimization. CONCLUSIONS: In order to prevent IPV, further qualitative research is required to evaluate the involved risk factors and training programs on how to behave against violence in association with the legal rights should be designed for poorly educated women in their natural settings and hospitals.

Consistency of postmortem interval estimations of physicians using only postmortem changes of putrefied dead bodies.

The postmortem interval is estimated based on physical, biochemical, and morphologic changes in dead bodies, scene investigation findings, and judicial investigation findings. Many factors affect the onset and the course of the postmortem changes. There is no established method for accurate estimation of the postmortem interval, especially with regard to putrefied dead bodies. Aiming to determine the consistency and the variation of postmortem interval estimations in cases with various putrefaction degrees by forensic medicine assistants and specialists from different centers, a prospective study was undertaken. A form containing data about the time, environment, and geographical location where the cases were found, along with their postmortem changes was mailed to 110 forensic medicine assistants and specialists from different centers, who were also asked to note their postmortem interval estimations. About half of the forms were returned. Those postmortem interval estimations made based on the information included in the forms, showed great variability between the participants, and in only 6 cases a consistency exceeding 50% was found between the participants and the autopsy teams. It is not possible to estimate the postmortem interval in a standard way by using only the postmortem changes of putrefied bodies. Therefore, especially in the cases involving putrefied bodies, in addition to the postmortem changes, factors such as environmental conditions, the scene, and judicial investigation findings should be taken into consideration.

Infection control implementations at forensic medicine practice: a national survey in Turkey.

Because forensic medicine workers have a greater occupational risk for infectious diseases, strict rules and measures against infections must be implemented at every stage of forensic medicine practices. In this study, we aim to evaluate the infection control implementations in forensic medicine practices in Turkey.A questionnaire survey was mailed to forensic medicine specialists and residents between April and June 2005. The questionnaire consisted of 36 questions whose designed was based on standard precautions and protective barriers against infectious risks.In all, 111 doctors from 27 different cities responded to the questionnaire. Of those doctors who responded, 43.2% reported performing external examination anywhere. The percentage of doctors performing external examinations who regularly wore gloves, masks, and gowns, and washed hands with a disinfectant were 81.5%, 24.7%, 30.9%, and 81.5%, respectively. The percentage of doctors performing autopsies who regularly wore masks, protective eye-wear, gloves, special gloves, and special boots were 59.6%, 10.6%, 98.9%, 71.3%, and 36.2%, respectively. Only 2 negative pressure rooms were reported.According to these results, precautionary measures against infectious risks in forensic medicine practice in our country are insufficient. Conditions to facilitate and to improve the compliance with infection control procedures must be prepared.

Deaths from drug overdose and toxicity in Turkey: 1997-2001.

Turkey is located on the main overland connection between Asia and Europe, making the country potentially vulnerable to drug trafficking and its associated harms. The aim of the present study is to explore the frequency of all deaths from drug overdose and toxicity in Turkey and to describe some of the characteristics of these deaths. We collected data on all deaths from drugs in Turkey between 1997 and 2001 using records from the Council of Forensic Medicine. Data obtained from autopsy reports were retrospectively analyzed. In the present study, 374 deaths from drugs were reported in Turkey, with a mortality rate of 0.17 per 100,000 population. Highest mortality rates were found in Istanbul (0.83) and Gaziantep (0.71). The mean age was 34.0, and most cases (71.7%) were below the age of 40. The proportion of female cases was 13.6%. Opiates were implicated in 91.5% of deaths and benzodiazepines in 25.9%. Two fifths (38.8%) of the cases involved use of more than 1 drug. In 36.6% of cases, the route of final drug administration was by injection. The most common location of death was at a home (33.7%). Interventions to reduce drug use nationally are urgently required. International cooperation in social-educational activities, scientific research, and security measures is essential for this war.

Fatal occupational injuries in the construction sector in Kocaeli, Turkey, 1990--2001.

In Turkey, the construction sector is responsible for the largest number of work-related fatalities among all industries. This study's objective is to determine the characteristics of the fatalities in the construction sector in Kocaeli Province. The study was carried out retrospectively by investigating the records of occupational deaths between 1990 and 2001 in the Kocaeli District of Turkey. Fatal occupational injuries in the construction sector were investigated in detail by evaluating the records. The analysis was based on data from 153 deaths. The incidence of occupational injuries was found overall to be 4.5% in Kocaeli, while the annual mortality rate was 60.4 in Kocaeli and 79.0 in Turkey per 100,000 workers over the entire time period. On the other hand, the fatality rate of occupational injuries was found to be 12.0 per 1,000 in Turkey and 6.4 per 1,000 in Kocaeli. The evaluation of the type of injuries in construction sector has revealed that in 69 of cases (45.1%) fell down from high altitude, in 22 cases (14.4%) vehicle accident, and in 22 (14.4%) electrocution were the cause of death. The leading causes of death have been found to be blunt-force trauma (37.9%) and head trauma (25.5%). Fourty one percent of those who had occupational accidents have had less than one year work experience. Only in 7.8% of deaths, the cause was determined through an autopsy.

Suicidal deaths in childhood and adolescence.

Suicide has been reported as the second or third most common cause of death in children and adolescents worldwide. In this study, cases of under the age of 19 years submitted to the Institute of Forensic Medicine, First Specialization Board between 1996 and 2000 as suicides by the Board were evaluated retrospectively. The cases included in this study were the cases bearing locally questionable components, so had been submitted to the evaluations by the Board in order to eradicate the doubts. A total of 43 cases were investigated regarding age, gender, cause of death, manner of death, place of death, time of death, and the risk factors. Of the 43 cases evaluated, 31 cases were female and 12 cases were male. The notable suicide method was found to be firearms. Although it was clear that that not all of the suicide cases in this age group had been submitted to the Institute of Forensic Medicine, the most striking result of this study, nevertheless, was that girls constituted the 72% of suicidal deaths in this age group.

Fatal occupational injuries among workers in Kocaeli, Turkey, 1990-1999.

The authors evaluated occupational accidents in Kocaeli, Turkey, using epidemiologic criteria. Data were derived from the registries of the service on Occupational Injuries and Diseases of the Social Insurance Institution's District Authority in Kocaeli. The analysis was based on data from 387 deaths. The rates of occupational injuries and mortality and fatalities from them were 5.1%, 30.6 per 100,000 workers, and 6.0%, respectively, compared with 2.8%, 35.2 per 100.000 workers, and 12.7% in Turkey. Sectors with the highest rates of fatal occupational injuries were construction (30.2%), transportation (13.2%), basic metal industry (9.0%), manufacturing of metal products (5.9%), and heating with electricity, gas, and steam (5.9%). 38.2% of these workers were 25-34 years old. Nearly all were male, most were married, and three fourths had children. Of all deaths due to occupational injuries, 121 (31.3%) were caused by traffic injuries, 93 (24.1%) by falling from high places, and 43 (11.1%) by electrocution; 89% occurred at workplaces, 42% of the workplaces were small, and 45.9% of the deceased workers had been working there for less than three months. Although the situation was better than that in the rest of Turkey in terms of epidemiologic criteria, the death rates, as in other developing countries, are higher than those in the world in general.