Protective and Supportive Injunctions for Children Exposed to Sexual Abuse: The First Data from Turkey

Child sexual abuse (CSA) requires multidisciplinary approach by forensic, social, and medical services, thus Child Advocacy Centers (CACs) have been established to evaluate CSA cases in Turkey. At CACs the social needs of children are assessed by social workers. Protective and supportive injunctions (PSIs) are considered at each step of evaluation and are proposed to child courts. This study aimed to evaluate PSIs at a local CAC, which is one of the leading CACs in Turkey. The study group consisted of children and adolescents exposed to CSA admitted to Izmir CAC between April 2014 and April 2015. Socio-demographic characteristics, social investigation reports, psychiatric reports, and proposed PSIs were evaluated. The rate of social investigation necessity was 28.3% (n = 113), and the rate of being proposed for at least one PSI was 24.3% (n = 97). The most common proposed injunctions were maintenance care injunctions (n = 47; 48%) and counseling injunctions (n = 46; 47%). The rate of proposed PSIs was significantly higher in adolescents, incest cases and abuse types including penetration than in the other groups. This is the first study to evaluate PSIs in the child protection system. Our results provide data about the risk groups that need PSIs among the victims of CSA cases

A new model in evaluating child sexual abuse: Child Advocacy Centers

Child Advocacy Centers (CAC), are newly established centers where professionals working in the field of child sexual abuse which can display a multidisciplinary approach. The first CAC in Turkey was established in 2010 and they are, now, increasing in number all around the country. The basic goal of CACs is to prevent the secondary abuse due to repeating interviews especially during forensic process. Forensic interview in CACs, is based on the thought that the child tells about this special event to professionals specially trained in a specially structured mirrored room and child-friendly environment. During this special interview, representatives of each institute gathers their own data. Videorecording of this interview minimizes the need for further explanation. After the interview, both the forensic is initiated and the child is provided with all social and healthcare services in a child-friendly environment. It is important to support CACs to maintain appropiate approach in child sexual abuse all around the country

Role of Hematological Parameters in the Diagnosis of Juvenile Idiopathic Arthritis in Children with Arthritis

Early diagnosis and treatment of arthritis are essential for the prognosis of the disease. Especially during the active phase of juvenile idiopathic arthritis (JIA), a prompt diagnosis is necessary to manage the disease properly. New inflammation markers such as neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), mean platelet volume (MPV), and platelet distribution width (PDW) have been investigated in various inflammatory disorders. This study aimed at the diagnostic value of NLR, MLR, MPV, and PDW in differentiating JIA in children with arthritis. Patients and Method: Case-control study with 324 children with arthritis (case group) and 324 healthy children (control group). Additionally, children with arthritis were grouped into JIA and non-JIA. Medical records of children aged 0-18 were retrospectively reviewed. Hematological parameters at the time of diagnosis were recorded. NLR, MLR, MPV, and PDW were analyzed in the study groups. Results: In the case group, 52.8% were boys, and 47.2% were girls; the mean age was 7.7 +/- 4.0 years. The NLR in the case group was significantly higher than the control one (p = 0.001). The mean MPV was lower in the case group than the control group (p = 0.001). There were no differences in NLR and MPV between JIA and non-JIA groups (p = 0.062, p = 0.689). The JIA group's mean PDW was lower than the non-JIA group (p = 0.001). Conclusion: The increase in NLR may indicate inflammation but has no superiority in distinguishing JIA from other arthritis causes. Platelet distribution width was lower in JIA patients, but its clinical utility is limited

Trichobezoar in Vagina: Assessment for Child Sexual Abuse and Diagnostic Result of Forensic Science

Vaginal discharge and bleeding in children require a through and thoughtful evaluation to diagnose the underlying problem including infections, sexual abuse, and vaginal foreign bodies. We report a 6-year-old girl presenting with bloody vaginal discharge, carefully evaluated for sexual abuse, and finally diagnosed as a vaginal foreign body after vaginoscopy. A rolling hair ball was extracted from the vagina and was diagnosed as trichobezoar pathologically without any endo-ecto-mesodermal residual tissue. The hair ball was genetically detected and diagnosed to belong herself by containing no foreign structure. Child sexual abuse was ruled out by forensic interview at CAC and report of forensic science that reported genetic structure belonging to the child. Medicolegal assessment helped in final diagnosis to exclude child sexual abuse

Does mold sensitivity cause adenoid hypertrophy in children?

Objective: Chronic adenoid infections, and allergic inflammation lead to development of adenoid hypertrophy. One of the major causes of allergic rhinitis due to allergic inflammation is indoor allergens, mainly house dust mites and molds. In this study, it was aimed to investigate the frequency of mold fungi sensitivity in the etiology of allergic rhinitis caused by adenoid hypertrophy in children