A retrospective analysis of cardiovascular deaths: A 5-year autopsy study of 1045 cases in Antalya, Turkey.

This study aims to identify the macroscopic and microscopic changes that occur in the heart in different causes of cardiovascular death and sudden cardiac death in autopsy cases and evaluate the difficulties that a forensic practitioner may encounter during autopsies. All forensic autopsy cases in the Morgue Department of the Council of Forensic Medicine, Antalya Group Administration between January 1, 2015, and December 31, 2019, were examined, retrospectively. The cases were chosen according to inclusion and exclusion criteria, and their autopsy reports were examined in detail. It was determined that 1045 cases met the study criteria, 735 of which were also met the sudden cardiac death criteria. The top three common causes of death were ischemic heart disease (n = 719, 68.8%), left ventricular hypertrophy (n = 105, 10%), and aortic dissection (n = 58, 5.5%). The frequency of myocardial interstitial fibrosis was significantly higher in deaths due to left ventricular hypertrophy than in deaths due to ischemic heart disease and other causes (χ2 (2) = 33.365, p < 0.001). Despite detailed autopsy and histopathological examinations, some heart diseases that cause sudden death may still not be detected.

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 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.

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.

Suicide of elderly persons: towards a framework for prevention.

Suicide is an act of intentionally terminating one's own life. Although suicide rates vary across demographic categories, they have increased by approximately 60% in the last 50 years. Many studies of adolescent suicidal behavior have noted impulsivity to be a common feature in the younger age group, while with older people there is evidence of planning and a strong intent to die. In fact, older people are most successful as an age group with approximately one in four attempts resulting in death. While very comprehensive statistics are available on many aspects of this problem for the Turkish population as a whole, this data does not include physical factors like illnesses, legal domiciles like nursing homes, economic standards and history of attempted suicides. This necessary data would add greatly to the available data and accuracy of research in this area. Whereas Turkish national risk factor procedures are available, precaution procedures and suicide attempt data is not. There is no way of knowing how many deceased had a history of repetitions. It is suggested that this could be attributed to routine failure to observe and mitigate risk factors. The size of this problem is being demonstrated with this presented case report about a planned complex suicide with multiple sharp forced injuries and substance intoxication; a completed suicide that was potentially preventable with timely detection and intervention. In accordance, suicidal risk factors in the old age population, precautions, along with the characteristics of this suicidal case, are evaluated within existing published work.

A case of pentacuspid pulmonary valve.

A pentacuspid pulmonary valve is a rare congenital anomaly. The present report describes a case of pentacuspid pulmonary valve encountered during the autopsy of a 50-year-old man with a ruptured abdominal aortic aneurysm. The pentacuspid pulmonary valve had three relatively equal cusps and two smaller cusps. In this case, a tricuspid aortic valve was identified with normal structure and no evidence of heart failure was found clinically or pathologically.

Microsatellite instability is a common finding in multiple myeloma.

PURPOSE: Microsatellite instability (MSI) occurs as a result of sliding in the DNA sequences from shortening or elongation of the repeat zones of DNA during replication. Such abnormalities can normally be corrected by the enzymes coded by the DNA mismatch repair (MMR) genes. Therefore, detection of MSI is considered to be a sign of disorder of the MMR genes and is interpreted as a replication error phenotype. PATIENTS AND METHODS: We evaluated the MSI in 5 different loci in the 14q32 region of immunoglobulin heavy chain IgH gene in 26 newly diagnosed patients with multiple myeloma (MM). RESULTS: Fifty-four percent of the patients disclosed MSI and at least 1 locus but no significant association of MSI was found between different clinical stages and the MM subtype. MSI was not found in 5 light-chain myeloma patients. CONCLUSION: Although our case number is small, probably the genomic instability in heavy-chain MM may be a common finding and probably plays a critical role in the MM pathogenesis.

Population study of six short tandem repeat loci in Antalya, Turkey.

Population studies of six short tandem repeat loci were carried out in a sample of unrelated Turkish individuals living in Antalya province, southwest Turkey. After electrophoresis in polyacrylamide gels, 8 alleles could be identified for THO1, 6 for TPOX and CSF1PO, 9 for VWA, 7 for FES, and 14 for F13A01. There was a significant deviation from the Hardy-Weinberg equilibrium between observed and expected values for FES and TPOX loci.