Medico-legal Approach to Poisoning Cases in the First Decade of Life

WOS: 000359063800004Objective: In developing countries such as Turkey, high mortality rates associated with childhood poisonings are an important problem that needs to be solved. This study aims to discuss the points to be considered about the medico-legal approach to childhood poisoning cases in emergency services and to provide regional data about childhood poisoning cases. Materials and Methods: Patient files (n=62,999) belonging to patients who applied to the Ege University, Faculty of Medicine, Pediatric Emergency Unit between January 01, 2012 and June 30, 2013 were examined retrospectively. Demographic data, poisoning type and location, physical examination findings, consultations, and the decisions about treatment and hospitalization belonging to 271 poisoning cases aged between 0 and 9 years were evaluated. Results: From a total of 271 first decade childhood poisoning cases, 145 were females and 126 were males. The mean age was 2.78 +/- 1.83 years. The first application reason to the emergency service was taking/doubt about taking medications (n=141, 52.0%). One hundred and eighty-one cases were discharged from the emergency service after the examination process, 56 (20.7%) cases were hospitalized, 29 cases (10.7%) refused the treatment, and five cases (1.8%) left the hospital without permission. Conclusion: Childhood poisoning cases are still a problem in Turkey. In addition, governmental centers for preventing poisoning are required. For both managing the legal case and planning the treatment, performing detailed systemic examination and collecting information about the poisoning are the most important steps. Moreover, increasing the awareness of parents about their protection obligations and informing them about child neglect and precautionary warnings could be for the benefit of families and the society

[Hekim Bakış Açısı İle Cinsiyetin Hekimlik Mesleğine Etkisi]

The legislation on patients' rights in the world and in Turkey has guaranteed the right of choosing their health care practitioners for patients. In this study, it is aimed to evaluate the viewpoints of physician assistants of Ege University Faculty of Medicine (EUFM) about the effect of physician's gender on choosing the physician. After taken the permission from EUFM Ethic Committee of Clinic Researches, this study was performed with 100 voluntary physician assistants who work in EUFM. In this context, a questionnaire was performed. Survey responses were evaluated with statistical program. 51 participants were males and 49 were females, the average age was 28.8;plusmn;3.6. 72% expressed that gender should not be a criteria while choosing the physician. 62% of the respondents mentioned that there was an increase according to the gender of physician. 17% of physician mentioned that their gender had a negative effect to their careers. Taken cognizance of the socio-cultural structure of our country it is thought that coming to the forefront of physicians' gender in the patients' selection of their physicians would cause many problems in the health care system notably related to diagnosis and treatment of patients.Dünyada ve Türkiye'de hasta hakları ile ilgili mevzuat, hastaların kendilerine sağlık hizmeti verecek hekimi seçme hakkını güvence altına almıştır. Bu çalışmada, Ege Üniversitesi Tıp Fakültesi (EÜTF) asistan doktorlarının, hekimin cinsiyetinin hastaların hekim seçimindeki etkisine bakış açılarının değerlendirilmesi amaçlanmıştır. Bu çalışma, EÜTF Klinik Araştırmalar Etik Kurulu'ndan alınan izin sonrasında EÜTF Hastanesi'nde çalışan 100 asistan doktorun çalışmaya gönüllü olarak katılımı ile gerçekleştirildi. Bu kapsamda, hekimlere anket uygulandı. Ankete verilen yanıtlar bilgisayar ortamına yüklenerek değerlendirildi. Katılımcıların 49'u kadın, 51'i erkek olup, yaş ortalaması 28.8±3.6'dır. %72'si hastaların hekim seçme hakkı kapsamında cinsiyetin bir kriter olarak yer almaması gerektiğini bildirdi. Anketi cevaplayanların %62'si cinsiyetin belirleyici bir faktör olma durumunda artış olduğunu belirtti. Hekimlerin %17'si cinsiyetinin meslek hayatına olumsuz etki ettiğini bildirdi. Ülkemizin sosyokültürel yapısı göz önüne alındığında hastaların hekim seçiminde cinsiyetin ön plana çıkma durumunun, başta hastaların tanı ve tedavi süreci ile ilgili olmak üzere sağlık sisteminde pek çok olumsuzluğa yol açabileceği düşünülmektedir

Gender's Effect to the Profession of Medicine from the Physicians' Perspective: A Questionnaire Study [Hekim Bakis Acisi ile Cinsiyetin Hekimlik Meslegine Etkisi: Bir Anket Calismasi]

The legislation on patients' rights in the world and in Turkey has guaranteed the right of choosing their health care practitioners for patients. In this study, it is aimed to evaluate the viewpoints of physician assistants of Ege University Faculty of Medicine (EUFM) about the effect of physicians gender on choosing the physician. After taken the permission from EUFM Ethic Committee of Clinic Researches, this study was performed with 100 voluntary physician assistants who work in EUFM. In this context, a questionnaire was performed. Survey responses were evaluated with statistical program. 51 participants were males and 49 were females, the average age was 28.8±3.6. 72% expressed that gender should not be a criteria while choosing the physician. 62% of the respondents mentioned that there was an increase according to the gender of physician. 17% of physician mentioned that their gender had a negative effect to their careers. Taken cognizance of the socio-cultural structure of our country it is thought that coming to the forefront of physicians gender in the patients selection of their physicians would cause many problems in the health care system notably related to diagnosis and treatment of patients. [Med-Science 2015; 4(1.000): 1895-911

The characteristics of older people suicides by sex and age subgroups

PubMed: 32492558As 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. © 2020This study was performed with the permission of Istanbul Forensic Medicine Institute, Turkey

Laypersons can successfully place supraglottic airways with 3 minutes of training. A comparison of four different devices in the manikin

<p>Abstract</p> <p>Introduction</p> <p>Supraglottic airway devices have frequently been shown to facilitate airway management and are implemented in the ILCOR resuscitation algorithm. Limited data exists concerning laypersons without any medical or paramedical background. We hypothesized that even laymen would be able to operate supraglottic airway devices after a brief training session.</p> <p>Methods</p> <p>Four different supraglottic airway devices: Laryngeal Mask Classic (LMA), Laryngeal Tube (LT), Intubating Laryngeal Mask (FT) and CobraPLA (Cobra) were tested in 141 volunteers recruited in a technical university cafeteria and in a shopping mall. All volunteers received a brief standardized training session. Primary endpoint was the time required to definitive insertion. In a short questionnaire applicants were asked to assess the devices and to answer some general questions about BLS.</p> <p>Results</p> <p>The longest time to insertion was observed for Cobra (31.9 ± 27.9 s, range: 9-120, p < 0.0001; all means ± standard deviation). There was no significant difference between the insertion times of the other three devices. Fewest insertion attempts were needed for the FT (1.07 ± 0.26), followed by the LMA (1.23 ± 0.52, p > 0.05), the LT (1.36 ± 0.61, p < 0.05) and the Cobra (1.45 ± 0.7, p < 0.0001). Ventilation was achieved on the first attempt significantly more often with the FT (p < 0.001) compared to the other devices. Nearly 90% of the participants were in favor of implementing supraglottic airway devices in first aid algorithms and classes.</p> <p>Conclusion</p> <p>Laypersons are able to operate supraglottic airway devices in manikin with minimal instruction. Ventilation was achieved with all devices tested after a reasonable time and with a high success rate of > 95%. The use of supraglottic airway devices in first aid and BLS algorithms should be considered.</p

Demonstration of ventricular myocardial extensions into the pulmonary artery and aorta beyond the ventriculo-arterial junction

WOS: 000245642600014PubMed ID: 17437578Background: A subgroup of outflow tract (OT) ventricular tachycardias (VT) originate from the aortic sinuses or the main stem of the pulmonary artery. The anatomic substrate for these tachycardias is unknown. The aim of this study was to investigate the presence of ventricular myocardial extensions (VME) into the pulmonary artery (PA) and aorta (Ao) beyond the ventriculo-arterial junction (VAJ) and determine the anatomical and histological characteristics of these muscle extensions. Methods: Ninety-five consecutive human hearts obtained at autopsy were studied. Longitudinal strips of tissue containing each cusp, aortic, and pulmonary artery walls and left and right ventricular outflow tracts were excised and histologically analyzed. Anatomical measurements, including length and thickness of VMEs, obtained at autopsy, were made. Results: VMEs beyond the VAJ were found in 21 of 95 (22%) patients studied. VMEs were found in 16 of 95 PAs (17%) and 7 of 95 Aos (7%) were examined. VMEs were located within the adventitia in 23 (88%) and on the epicardial surface in three (12%). The majority of VMEs were in continuity with the underlying ventricular OT muscle tissue. Myocellular hypertrophy and fibrosis were present in 19 (73%) and fatty tissue between the layers of VME in 18 (69%). Clinical data were available in 14 of 21 patients with positive VME. None of the patients (clinical data available group) had history of cardiac disease or signs or symptoms (palpitations or syncope) of cardiac disease. Conclusions: VMEs into the PA and Ao beyond the VAJ are relatively common. It seems that their mere presence does not predispose to OT VTs. There are probably intrinsic arrhythmogenic properties in tissues specific to these regions in those patients who develop OT VTs