Incidental Findings on Computerized Tomography Images of Trauma Cases.

BACKGROUND: This study aimed to evaluate the characteristics of incidental findings (IFs) on computed tomography (CT) scans of trauma admissions, examine associations between IFs and gender and age-groups, and discuss the management strategies. METHODS: The CT reports were retrospectively reviewed to evaluate IFs. Cases were divided into five age-groups (0-19, 20- 39, 40-59, 60-79,≥80). IFs were classified as "Group 1": congenital anomalies that do not require further investigation, non-degenerative/minor degenerative findings; "Group 2": findings that do not require immediate intervention, require outpatient follow-up/in case of symptoms; and "Group 3": findings that require immediate intervention/further investigation. RESULTS: There were 2385 CT scans and 1802 incidental findings (IFs) in 783 trauma cases. CT scans with IFs constituted 50.2%. The percentage of IFs was 75.6% in males and 24.4% in females, and they occurred in 4.8%, 27.6%, 44.3%, 20.9%, and 2.4% of age groups 1 to 5, respectively. Group 1 had 34.6%, group 2 had 54.6%, and group 3 had 10.8% IFs. There was not any significant association between the classification and gender or age-groups. In terms of organs, IFs of the thyroid and gall bladder & bile ducts were significantly higher among females (P=0.044 and P<0.001, respectively), while IFs in the head & neck region were significantly higher in males (P<0.001). Incidental findings in the kidney, liver, adrenal gland, and vascular structures differed significantly across age-groups (P<0.05). CONCLUSION: There were no significant relationships between the classification of IFs and gender or age-groups. However, the distribution of IFs was significantly associated with gender and age-groups in terms of organs. Healthcare professionals should consider this relationship when following up and treating patients.

Estimation of sex from computed tomography images of skull measurements in an adult Turkish population.

BACKGROUND: Nowadays, data on the anthropometric measurements of populations is needed in many areas, especially forensic and legal. Using various methods, researchers obtain various data such as race, sex, and age, and thus provide identification of the material used. Morphological or metric methods are often used for identification. PURPOSE: To evaluate the usefulness of the results of skull measurements using computed tomography (CT) to determine sex in a Turkish population. MATERIAL AND METHODS: We analyzed 300 male and 300 female CT images of Turkish individuals with an age range of 21-50 years. Maximum cranial length, maximum cranial breadth, bimastoid diameter, bizygomatic diameter, and bigonial breadth were measured by CT tomography. All data were subjected to discriminant function analyses for estimating sex. Intra-observer and inter-observer variances of the measurements were examined using intraclass correlation coefficient analysis. RESULTS: Discriminant function analysis indicated that there was a significant difference between male and female with 88% accuracy. Discriminant function for estimation of sex was obtained with satisfactory accuracy rates for the parameters used. CONCLUSION: This study confirms that skull measurements show sexual dimorphism in the Turkish population, and also suggests that it may be useful to use CT to assess skull anthropometric measurements.

Sex estimation from foramen magnum parameters in adult Turkish population: A computed tomography study.

Identification of skeletal relics is crucial for medicolegal purposes. Sex estimation is one of the critical parts providing the identification of skeletal relics. In forensic practice, sex estimation requires multidisciplinary studies of such as forensic medicine, anatomy, dentistry and radiology. Recently, radiological studies on this subject have been increasing with the developing technology. The objective of this study is to examine the usage of radiological dimensions of foramen magnum for sex estimation in human skulls by developing discriminant functions in Turkish population. We analyzed 600 (300 males and 300 females) Computerized Tomography (CT) images of Turkish individuals aged between 21 and 50. Four measurements were obtained from CT images. All measurements in males were significantly greater than in females, and they provided the higher sex classification accuracy. The area of the foramen magnum calculated by Radinsky's formula was the best measurement for sex estimation with a 75% accuracy rate. In conclusion, the CT images of foramen magnum show sexual dimorphism in our population. To use population specific data would be the most appropriate approach for sex estimation.

The characteristics of older people suicides by sex and age subgroups.

As the older population steadily grows, a corresponding increase in elderly suicides is also expected. In addition, due to differences in the physical and psychosocial characteristics of this age group, the characteristics of elderly suicides are predicted to be different to those of other groups. In this study, we aimed to report the characteristics of suicides 60 years and older according to sex and age subgroups. We retrospectively reviewed the autopsy reports of individuals aged 60 and older who committed suicide in Turkey during the 10-year period between 2005 and 2014. Their age, sex, cause of death, and year, month, season, place, and method of suicide were analyzed. Comparisons were made based on sex, age subgroup, demographic variables, and descriptive characteristics of the suicides. Of 17,942 forensic autopsies, 525 were elderly suicides. Of these, 77.3% were men and the mean age was 71.26 ± 8.16 (range, 60-94) years. There were statistically significant differences in suicide method according to sex (p < 0.001, X = 43.984) and age subgroups (p = 0.001, X = 51.457). For both sexes, hanging was the most common suicide method (59.4%) and the majority of suicides occurred at home (73.1%). The suicides occurred more frequently in the 65-74 age subgroup, in the summer, and in the months of June and July. Identifying the characteristics of elderly suicides, especially by sex and age subgroups, may be beneficial for suicide risk assessment and the development of prediction and prevention programs.

Forensic Cases in the Operating Room: Knowledge and Practices of Physicians and Nurses.

PURPOSE: The purpose of this study was to investigate physicians' and nurses' knowledge and practices regarding forensic cases in the operating room. DESIGN: This is a descriptive study. METHODS: The sample consisted of 139 physicians and 59 nurses working in the operating rooms of a university hospital. Data were collected via a question form prepared by the researchers. FINDINGS: Approximately half of the physicians and nurses did not know whether a patient brought to the operating room was a forensic case. Most of the physicians and nurses working in the operating room felt their knowledge and practice regarding the preservation and storage of evidence in forensic cases was inadequate. CONCLUSIONS: The results of this study highlight the necessity of an increased focus on forensic case process.

Childhood sexual abuse and supportive factors.

BACKGROUND: Childhood sexual abuse (CSA) can be a devastating life experience and is associated with a higher incidence of mental disorders and suicide attempts. The aim of this study was therefore to identify predictors of mental disorder and suicide attempt in children and adolescents with a history of CSA. METHODS: A total of 181 Turkish children and adolescents with a history of CSA were evaluated for age, gender, suicide attempts, family relationships and educational background. Abuse involving the insertion of an organ or foreign object into the individual's body was designated as "qualified sexual abuse" (QSA); other forms of sexual abuse were designated "basic sexual abuse" (BSA). RESULTS: Suicide attempts were significantly higher in adolescent girls in the QSA subgroup; age, gender, family integrity, and school attendance were not associated with risk of mental disorders in this group. Among BSA patients, family integrity was significantly associated with suicide attempts. Suicide attempts were approximately 10-fold higher (OR, 10.154; 95% CI: 2.020-51.051; P = 0.005) in children from broken families. Family integrity and school attendance were also noted as weak protective factors against mental disorders in BSA patients. The incidence of mental disorders was 3.5-fold higher in children who had not been attending school (OR, 3.564; 95% CI: 1.379-9.211; P = 0.009). CONCLUSION: Family integrity and school attendance were weakly related with psychopathology (e.g. mental disorders or suicide attempts) in BSA survivors but not in QSA survivors. Female gender and puberty also increased the likelihood of suicide attempt in QSA survivors.

[The concept of mental health deterioration in light of decisions by higher judicial bodies]. / Yüksek yargi kararlari isiginda ruh sagliginin bozulmasi kavram.

Important arrangements were made to protect an individuals' sexual safety in the Turkish Penal Code. During judgments of sexual crimes, the witnesses of medical experts are usually used for evidence collection and for researching whether the crimes were aggravated. Due to this, reports are frequently requested from all physicians in all fields of medicine in their daily clinical practices by judicial authorities. Following implementation of the new Turkish Penal Code, the concept of mental health deterioration was frequently discussed and is still a discussed topic in the fields of both law and medicine in terms of crimes against sexual immunity. It is believed that subjects discussed in this article will provide important information for both adult, child and adolescent mental health professionals in terms of drawing attention to the importance of the medicolegal evaluations which are frequently requested from psychiatrists in their daily clinical practice and in terms of providing an evaluation of the concept of mental health deterioration in light of judicial decisions. Regarding the process from the beginning of application to the present, prejudications reduce questions about how the concept must be evaluated and what the meaning of the concept is. In this study, the decisions of Higher Judicial Bodies were researched and situations relating to how concepts must be evaluated and the meaning of the concept of mental health deterioration today in accordance with the prejudications were presented.

Radiological age estimation: based on third molar mineralization and eruption in Turkish children and young adults.

Radiographic evaluation of mineralization and eruption stages of third molars using dental panoramic radiographies can be an efficient tool for chronological age estimation in both forensic sciences and legal medicine. The third molar tooth is utilized for dental age estimation about the age span of 15-23 years because it represents the only tooth still in development. The aim of this study is to obtain and analyze data regarding third molar development and eruption in Turkish population for dental age estimation. A total of 744 dental panoramic radiographies of 394 female and 350 male subjects aged between 8 and 22 years were examined. Third molar development was determined according to the Nolla classification system, and eruption was assessed relative to the alveolar bone level. Mandibular and maxillary third molars were generally found at similar stages of development on both sides. Nolla stage 6 (completed crown calcification) was reached at around the age of 15 in both maxillary and mandibular third molars in both sexes. Alveolar emergence was at around the age of 16 in males and around age of 17 in females. Although third molars' eruption shows greater variability than development of third molars, data which were obtained from this study about eruption of these teeth can be supportive to development data for age estimation.

Watch out for nuts in your travels: an unusual case of drug-facilitated robbery.

Among many methods to facilitate robbery is spiking unsuspected victims' food or beverage with drugs. In this short report, we would like to present a highly unusual and a very creative case of drug-facilitated robbery to highlight the possibility of this type of case in the field of travel safety.