Evaluation of Central and Peripheral Retinal Vascular Changes in the Fellow Eyes of Patients with Unilateral Retinal Vein Occlusions

Objectives: To evaluate the subtle peripheral retinal and macular vascular changes in the fellow eyes of patients with unilateral retinal vein occlusion (RVO). Materials and Methods: This retrospective study included 53 patients with unilateral RVO and 44 age-matched controls. The frequency of peripheral retinal vascular pathologies in both eyes was evaluated using high quality ultra-wide field fluorescein angiography (UWFFA). Macular vascular density, flow area, and foveal avascular zone measurements from optical coherence tomography angiography (OCTA) were analyzed together with laser flare photometry values in patients and controls. Results: Peripheral retinal vascular pathologies were detected on UWFFA in the fellow eyes of 36 (67.9%) patients. No significant central vascular pathologies were detected on OCTA and there was no significant difference in OCTA parameters between the fellow eyes and the controls. Flare values did not differ significantly between the control and the fellow eyes. Conclusion: Two thirds of the fellow eyes of unilateral RVO patients had subtle peripheral retinal vascular changes, while there was no significant microvascular change detected with OCTA in the macula. This suggests that vascular changes caused by systemic vascular disorders probably first start in the peripheral retina of the fellow eyes of patients with RVO.

Deadly stays: A 10-year autopsy study of deaths in hotels in Antalya, Turkey.

The hotel industry is essential for travelers, for both touristic and business purposes. Deaths in hotel rooms, which can occur in various manners from various causes, can result in serious problems for the industry. This study evaluated 8137 autopsies performed by the Antalya Group Administration of the Turkish Council of Forensic Medicine between January 1, 2010, and December 31, 2019. All deaths occurred during a hotel accommodation and within hotel borders, including their respective beach areas, and those who collapsed during their hotel stay and died shortly afterward in a hospital or on their way to a hospital were included. A total of 900 cases were identified and ultimately included in this study. According to the autopsy reports, the decedents who died during their stays were from 42 different countries and had a mean age of 54.3 ± 18.55 years. Most decedents were from Russia (n = 251, 27.9%). The most common manner of death was natural causes (n = 552, 61.3%) followed by accidents (n = 284, 31.6%), suicides (n = 40, 4.4%), and homicides (n = 7, 0.8%). Existing cardiovascular diseases (n = 379, 42.1%) were the leading cause of death, followed by drowning in the sea (n = 116, 12.9%) or a pool (n = 58, 6.4%). Most of the causes of deaths identified within this study are preventable with timely intervention or resuscitation. Providing medical personnel 24/7 with adequate equipment in accommodation options, and enabling hotels to take appropriate measures may decrease preventable deaths and improve international travel.

The Relationship between Anxiety and Depression Levels with Perceived Stress and Coping Strategies in Health Care Workers during the COVID-19 Pandemic.

OBJECTIVES: Coronavirus disease (COVID-19) has spread rapidly, locally and internationally after it started in Hubei province of China in December 2019. During the spread of this infectious disease in the world, health care workers are taking place as the main people in the screening and treatment of the disease. The present study aims to evaluate the relationship between anxiety and depression levels with perceived stress and coping strategies in health care workers during the COVID-19 pandemic. METHODS: In this study, 200 participants were included. Beck Anxiety Inventory (BDI), Beck Depression Inventory (BDI), Perceived Stress Scale-10 (PSS-10) and COPE (Coping Orientation to Problems Experienced) were applied. RESULTS: Mean scores for BDI and BAI were 9.2±8.9 and 8.2±9.2, respectively. BDI scores of 33 (16.5%) of 200 participants were ≥17. 62% of the participants had minimal depression, 21.5% of the participants had mild depression, 13.5 % of the participants had moderate depression, and 3% of the participants had severe depression according to BDI scores. 60.5% of the participants had minimal anxiety, 25.5% of the participants had mild anxiety, 8.5% of the participants had moderate anxiety and 5.5% of the participants had severe anxiety according to BAI scores. BAI and BDI scores of the female participants were statistically higher than the male participants. A statistically significant positive correlation was found between BAI and BDI scores and PSS-10 scores. A statistically significant difference was found in the averages of BAI and BDI, PSS-10 COPE 3 (Focus on and venting of emotions), 7 (Religious coping) and 13 (Acceptance) subscales levels in occupational groups. A statistically significant difference was found in BDI levels in the clinical units during the pandemic. CONCLUSION: This study indicated that different coping strategies can be used in health care workers regarding anxiety, depression and stress levels during the COVID-19 pandemic. While problem-solving and emotion-focused adaptive coping mechanisms help reduce symptoms, maladaptive and negative coping mechanisms can cause symptoms to exacerbate. Thus, training should be given to developing attitudes of health care workers to cope with stress.

Fatal Drowning Caused by A Swimming Pool Drainage System.

ABSTRACT: In swimming pools, malfunctions in the pool water drainage system can result with severe injuries, or even death, and mostly children are affected by these accidents. In this case report, the death scene and postmortem examination findings of a 12-year-old girl, who was trapped by her feet in the pool water drainage system, are reported. The external examination revealed ecchymotic areas with abrasions on both lower legs and both feet, suggesting suction of both feet through the uncovered pool drainage system opening. To prevent such accidents, safety practices related to the water circulation system should be developed in swimming pools and similar areas; children should be supervised at all times; and emergency medical teams, as well as lifeguards, should be available for immediate intervention.

The Knowledge Level and Opinions of Physicians about the Medical and Legal Procedures Related to Physical Child Abuse.

BACKGROUND: In order to diagnose child abuse, physicians need to consider the possibility of abuse in every child they encounter, have sufficient information about the topic and manage the cases according to current law. AIMS: To determine the knowledge level of physicians on child abuse and to learn their opinions about the procedures when they suspect child abuse. STUDY DESIGN: A questionnaire (cross-sectional) study. METHODS: A detailed questionnaire was applied to 390 physicians of whom 233 were general practitioners. The first part of the questionnaire included demographic variables (age, gender, occupational experience) and the frequency of child physical abuse cases encountered, since that is the most easily diagnosed and proven form of abuse. The second part consisted of 32 questions about diagnosis of physical child abuse and procedures during the follow-up of the cases. Statistical analyses were performed using SPSS version 18.0. RESULTS: Of the participating physicians, 47.4% (n=185) were female and only 13.1% of the physicians had some kind of postgraduate training on child abuse. The correct response rate of specialists compared to general practitioners was significantly higher. A total of 263 (72.3%) physicians thought that there was a specific law on physical child abuse in the Turkish Republic. More than two-thirds of physicians thought that reporting should only be addressed to Social Services and physicians should not be obliged to report to law enforcement. CONCLUSION: The results of the present study adds to the already known necessity for better training of physicians about physical child abuse and the need to refresh their knowledge through postgraduate courses. According to current regulations, it is obligatory to report abuse cases to the public prosecutor and/or police, therefore physicians also need training in respect of the legal status and medico-legal approach to these cases.

Microbial Safety and Shelf Life of UV-C Treated Freshly Squeezed White Grape Juice.

The effects of UV-C irradiation on the inactivation of Escherichia coli K-12 (ATCC 25253), a surrogate of E. coli O157:H7, and on the shelf life of freshly squeezed turbid white grape juice (FSWGJ) were investigated. FSWGJ samples were processed at 0.90 mL/s for 32 min by circulating 8 times in an annular flow UV system. The UV exposure time was 244 s per cycle. The population of E. coli K-12 was reduced by 5.34 log cycles after exposure to a total UV dosage of 9.92 J/cm(2) (1.24 J/cm(2) per cycle) at 0.90 mL/s flow rate. The microbial shelf life of UV-C treated FSWGJ was extended up to 14 d at 4 °C. UV exposure was not found to alter pH, total soluble solid, and titratable acidity of juice. There was a significant effect (P < 0.05) on turbidity, absorbance coefficient, color, and ascorbic acid content. Furthermore, all physicochemical properties were altered during refrigerated storage. The microbial shelf life of FSWGJ was doubled after UV-C treatment, whereas the quality of juice was adversely affected similarly observed in the control samples.

Suicidal childhood deaths with firearms in Antalya, Turkey.

The purpose of this study was to determine the characteristics of suicidal childhood deaths with the use of firearms that occurred from 2000 to 2009 in Antalya. The autopsy reports of the Antalya branch of the Turkish Forensic Medicine Council and judicial records were reviewed retrospectively. There were 60 suicidal deaths between 0 and 18 years of age. Firearms were used in 20 cases (11 males, 9 females). The shotgun (n = 15) was the most frequently used weapon. The site of bullet entries were the chest (n = 6), abdomen (n = 5), right temple (n = 5), mouth (n = 2) and neck (n = 2). Most suicides (n = 16) were in the home. In contrast to many other studies, the most frequently used weapon for suicides was the shotgun in this study.

[Double-level spinal cord injury without vertebral fracture or dislocation: a case report]. / Vertebra kirigi veya çikigi olmaksizin gelisen çift seviyeli omurilik yaralanmasi: Olgu sunumu.

Spinal cord injuries without evidence of vertebral fracture or dislocation on plain radiographs and computed tomography are referred to as SCIWORA (Spinal Cord Injury without Radiological Abnormality). This entity is seen more often in children due to the specific anatomical and functional properties of the pediatric spine. The aim of this study was to present a rare case in which SCIWORA occurred at two levels simultaneously with complete anatomic transection and to emphasize the importance of SCIWORA in forensic medicine. A three-year-old boy was admitted to the emergency department with paraplegia after being hit by a car. Computed tomography and plain radiographs failed to reveal any bone fracture or dislocation. However, magnetic resonance imaging showed loss of continuity with near-complete and complete anatomic transection of the spinal cord at the T3-4 and T6-7 levels. According to the literature, only two cases of double-level SCIWORA have been reported previously. However, this is the first case of double-level SCIWORA with complete anatomic transection. The mechanism of injury in the case reported here remains obscure regarding the forensic reconstruction of the event.

Modeling inactivation kinetics of liquid egg white exposed to UV-C irradiation.

The efficiency of UV-C irradiation as a non-thermal pasteurization process for liquid egg white (LEW) was investigated. LEW inoculated with Escherichia coli K-12 (ATCC 25253), pathogenic strain of Escherichia coli O157:H7 (NCTC12900) and Listeria innocua (NRRL B33314) were treated with UV light using a bench top collimated beam apparatus. Inoculated LEW samples were exposed to UV-C irradiation of known UV intensity of 1.314mW/cm(2) and sample depth of 0.153cm for 0, 3 5, 7, 10, 13, 17 and 20min. The populations of E. coli K-12, E. coli O157:H7 and L. innocua were reduced after 20min of exposure by 0.896, 1.403 and 0.960logCFU respectively. Additionally, the inactivation data obtained for each strain suspended in LEW was correlated by using Weibull (2 parameter), Log-Linear (1 parameter), Hom (2 parameter) and modified Chick Watson (2 parameter) models. The inactivation kinetics of E. coli K-12, E. coli O157:H7 and L. innocua were best described by modified Chick Watson model with the smallest root mean squared error (RMSE) (R(2)> or =0.92).

A case of suicidal ligature strangulation by using a tourniquet method.

Ligature strangulations are usually homicidal. Accidental and suicidal ligature strangulations are quite rare. In this study, an unusual case of suicidal ligature strangulation with a tourniquet method using a walking stick is presented.A 70-year-old-man was found dead in his room, a piece of cloth wrapped around the neck, knotted, and tightened by a walking stick. His hand was still on the walking stick which was seemingly used by him for a tourniquet effect. Autopsy showed bilateral sternocleidomastoid muscle hemorrhage. A thorough death scene investigation, detailed corpse examination, and autopsy are extremely important for determining the manner of death in such ligature strangulation cases.