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Objective: Informed consent is a term based on the idea that every individual has the right to know every medical intervention that is going to be performed on their own body and to learn the issues that she/he may encounter in case of refusal of intervention, and it also defines the protection of personal rights under the guarantee of law. Material and Methods: The website of Turkish Surgical Association and 25 different websites of surgical associations were evaluated according to general surgery association guide, which was published by the Turkish Surgical Association in 2011. Results: Four websites of those surveyed include informed consent sections and these were evaluated. A total of 44 informed consent forms were included in this study. Of these, 29 were in Turk Colon and Rectum Surgery Association, 8 were in Turkish Surgery Association, 5 were in Turk Hepatopancreaticobilier Surgery Association, and 4 were in Endocrine Surgery Association. These informed consent forms were evaluated with regard to the aforementioned criteria. The results and also the distribution according to the associations were summarized. A common feature of the informed consent forms was that all of them included the risks of the intervention/operation and complications to be carried out. On the contrary, none of them included approximate time of surgery, information about surgeons, issues that patients should care about before surgery, the section that permits the use of data for scientific purpose, and the time of signing the informed consent form. Conclusion: We believe that in this context the regulation of informed consent by sub-specialization associations under the flag of Turkish Surgical Association is a very important matter and will standardize informed consents; websites of the associations will be easier to access, and this will be as beneficial for physicians as the patients and also will protect the physicians in probable trials. [ABSTRACT FROM AUTHOR]

Abstract: The aim of this retrospective study was to differentiate complications from malpractices in surgical cases and to help specialists who work as court experts in malpractice litigations. We reviewed 366 malpractice cases notified to The Higher Health Council by Criminal Courts between 1995 and 2000. Of these, 93 had General surgical malpractice cases. The data showed that a large proportion of malpractice litigations against surgeons resulted from deviations of the surgeons from their own field of study. The surgeons did not obtain informed consent from patients in the majority of the cases. The rate of autopsy in deaths from malpractices was 79.6%. Fifty percent of malpractice litigations were groundless. It can be suggested that incessant exposure to criticisms and complaints may make innocent surgeons less willing to take risks for patients. [Copyright &y& Elsevier]

Sudden death due to acute pancreatitis has been rarely determined. A review of 3305 autopsies performed between 1991 and 2001 at the Council of Forensic Medicine found 12 cases (0.36%) with sudden death due to acute hemorrhagic pancreatitis without symptoms. A history of chronic alcohol ingestion was obtained from family in four cases (33%), and no stones were found in the bile ducts or in the gall bladders. During the autopsies, hemorrhage and edema were localized on the head of the pancreas in three cases and the whole pancreas in nine cases. The most common extrapancreatic pathology was found in the lung including pulmonary edema, alveolar hemorrhage, pleural effusion, and pulmonary congestion. There was no correlation between pulmonary and pancreatic damage. It is suggested that the forensic pathologists who are dealing with sudden unexpected death must not ignore the examination of pancreatic and extrapancreatic regions to avoid missing acute pancreatitis. [ABSTRACT FROM AUTHOR]

The most common type of burn among children is scalding burn. This study aims to reveal child abuse and neglect as a specific etiological factor that specific to our country, traditional teapot- and teacup-related scalding burns. Burn cases that admitted to our Burn Center were investigated, and among these, 72 cases suffering from scalding burns were included in the study. The interview forms issued upon admission of these cases were evaluated in detail. Out of 148 scalding burn cases, 48.6% were related to the use of traditional teapots and teacups. After a detailed assessment, all cases were considered neglect-related burns. As a result of considering the role of traditional teapots and teacups in pediatric injuries in our country, parents and caregivers should be warned about these types of injuries. Also, physicians must determine the possibility of child abuse or neglect in all pediatric burn cases. [ABSTRACT FROM AUTHOR]

In the geriatric population, forensic age estimation could be essential for insurance-related issues, retirement processes, and work permits. Although cases of forensic age estimation are dominant in adolescents and early adults, nowadays the practice of forensic age determination is increasing in the geriatric population as well. Forensic age estimation, in living and deceased individuals, is among the most commonly studied topics in clinical forensic medicine. However, only few studies have been performed for age estimation in the geriatric population. Based on skeletal bone morphology, skeletal bone radiological traits, chronological dental changes, facial traits, degenerative processes, and automated systems, there are several methods for forensic age estimation in adults and partly in the geriatric population. This paper aims to the draw attention of health-care professionals by discussing methods used for forensic age estimation in the geriatric population. [ABSTRACT FROM AUTHOR]

Background/aim: Pathophysiological changes due to Alzheimer disease and increasing age might result in situations requiring forensic evaluation in the elderly. Judicial bodies might need forensic evaluation of trauma and the decision-making capacity of Alzheimer patients. This study aimed to determine the demographic and clinical characteristics of Alzheimer patients seen for forensic evaluation. Materials and methods: Forensic records issued by the Department of Forensic Medicine of Hacettepe University in 2012 and 2013 were investigated. Patients with Alzheimer disease were included in the study and were analyzed in terms of age, sex, reason for application, comorbid medical conditions, occupation, and place and status of living. Results: There were 30 Alzheimer patients examined in the study period. Of these, 17 (56.6%) were male and 13 (43.3%) were female. The patients' ages ranged between 51 and 90 years, and the mean age was 78.7 years. The majority of cases (25, 83.3%) were transferred for evaluation of decision-making capacity, while only 5 (17.7%) were referred to our department for forensic reporting of bodily damage. Conclusion: Forensic reporting of bodily damage in Alzheimer patients is similar to common injury cases. However, in conditions requiring evaluation of decision-making capacity in Alzheimer patients, all records should be carefully examined and a complete neuropsychiatric evaluation should be performed. [ABSTRACT FROM AUTHOR]

Understanding the presence, transfer dynamics and depletion of gunshot residues (GSR) on various surfaces is crucial for preserving evidence, reconstructing shooting incidents, and linking suspects to crime scenes. This study aims to explore the transfer and loss of GSR on commonly encountered surfaces such as ceramic, glass, metal, paper, and plastic, as well as the influence of different common hand cleaning methods on secondary transfer. Using scanning electron microscopy (SEM) combined with energy dispersive X-ray analysis (EDX) and automated detection software, we quantified highly indicative three-component characteristic particles (lead, barium, and antimony) on cups made from ceramic, glass, metal, paper, and plastic. Furthermore, we evaluated the amount of secondary transferred particles on these surfaces following various post-discharge hand cleaning methods: washing with water and soap, washing with only water, wiping with wet wipes, or using paper towels. The results demonstrate that counts of secondarily transferred GSR particles vary significantly among surfaces. Specifically, the transferred GSR count was highest on paper, followed by plastic, ceramic, metal, and glass respectively. Post-discharge hand cleaning methods, including washing with water and soap, washing with only water, cleaning with wet wipes, or with paper towel, resulted in substantial loss of GSR count on transferred surfaces. Among these methods, washing with water and soap showed the highest depletion. The empirical evidence provided by our results underscores the importance of considering surface properties, post-shooting activities, and the methods of sample collection and analysis when interpreting transferred GSR analysis. Despite challenges, these insights enhance our ability to link suspects to shooting crimes through careful consideration of the entire context. [Display omitted] • GSR transfer to cups made of various materials via palmprints. • Paper cups hold highest number of GSR particles, then plastic, ceramic, metal, and glass. • Handwashing with soap drastically reduces number of transferred GSR particles compared to wipes/paper towels. [ABSTRACT FROM AUTHOR]

Background and objective: Ethyl glucuronide (EtG) and ethyl sulfate (EtS), minor metabolites of ethanol, aid to forensic scientist and clinicians to determine recent ethanol uptake when ethanol elimination is occurred. Present study aimed to show (a) kinetics of EtG and EtS in blood and urine after 0.5 g/kg ethanol intake (b) peak concentrations and time of disappearance in Turkish people. Material and methods: Seventeen (10 male, 7 female) healthy volunteers participated in the study. Blood and urine samples were obtained during 48 h after consumption and analyzed in LC-MS/MS. Results and conclusion: Blood peak concentrations of EtG and EtS were 0.13–0.389 mg/L and 0.211–0.5 mg/L, urine peak concentrations were 6.89–30.42 mg/L and 10.5–58.17 mg/L, respectively. There was no EtG and EtS in all samples 24 h later in blood and 48 h later in urine. Correlation was found between EtG and EtS concentrations in blood. Most of obtained data are similar to literature, except EtS dominancy to EtG in urine and blood. [ABSTRACT FROM AUTHOR]

Gallstone disease is very common and laparoscopic cholecystectomy is one of the most common surgical procedures all over the world. Parallel to the increase in the number of laparoscopic cholecystectomies, bile duct injuries also increased. The reported incidence of bile duct injuries ranges from 0.3% to 1.4%. Many of the bile duct injuries during laparoscopic cholecystectomy are not due to inexperience, but are the result of basic technical failures and misinterpretations. A working group of expert hepatopancreatobiliary surgeons, an endoscopist, and a specialist of forensic medicine study searched and analyzed the publications on safe cholecystectomy and biliary injuries complicating laparoscopic cholecystectomy under the organization of Turkish Hepatopancreatobiliary Surgery Association. After a series of e-mail communications and two conferences, the expert panel developed consensus statements for safe cholecystectomy, management of biliary injuries and medicolegal issues. The panel concluded that iatrogenic biliary injury is an overwhelming complication of laparoscopic cholecystectomy and an important issue in malpractice claims. Misidentification of the biliary system is the major cause of biliary injuries. To avoid this, the “critical view of safety” technique should be employed in all the cases. If biliary injury is identified intraoperatively, reconstruction should only be performed by experienced hepatobiliary surgeons. In the postoperative period, any deviation from the expected clinical course of recovery should alert the surgeon about the possibility of biliary injury. [ABSTRACT FROM AUTHOR]

Introduction: Today the number of applications for legal guardianship has increased among geriatrics. In Turkey, the assessment of legal guardianship is made within the framework of the 405th and 408th articles of the Turkish Civil Code. To the best of our knowledge, there are no published articles dealing with reports of legal guardianship for geriatric citizens. Therefore we aimed to evaluate legal guardianship reports in light of the related literature. Materials and Method: The records of the Department of Forensic Medicine of Hacettepe University Medical Faculty were used in this study. Patients' files and legal guardianship reports issued between the years 2011 and 2013 were investigated retrospectively. Geriatric cases (aged over 65) that had been referred for a legal capacity evaluation were included in the study. All cases were analyzed in terms of age, sex, occupation, existing psychiatric disorder or illnesses, the reason for legal guardianship, Mini Mental State Examination Test score and presence of dementia. Results: Of a total of 1306 cases, 36 (2.7%) were elderly patients referred for a legal guardianship examination. The ages of these cases ranged between 65 and 90. Sixty-one percent of the cases were evaluated in terms of TCC article 405 and 14% in terms of article 408. Of the total elderly cases, 81% (n=29) suffered from dementia, which in turn was due to Alzheimer's disease in 83% of the dementia cases. Conclusion: Our findings revealed that the most common medical condition requiring legal guardianship was dementia, of which the leading cause was Alzheimer's disease. [ABSTRACT FROM AUTHOR]

Aim: Electrical injuries are still responsible for significant morbidity and mortality; however, they are generally preventable with simple safety measures. This study aims to determine the general features of electrical fatalities, and to draw attention of health professionals towards such preventable deaths. Materials and methods: A retrospective evaluation of records of electrocution-related deaths in Ankara, Turkey, was conducted over 11 years (1998-2008). Results: Out of 12,263 autopsy cases, 100 (0.8%) were secondary to electrocution. Most of the victims were male (n = 94; 94%) while only 6 were female. Victims' age ranged from 1 year to 76 years, with a mean age of 33.5 years. Entry lesions were localized on the upper extremities in the majority of cases (n = 74; 74%). However, no electrical lesions were found in 3 cases. Of all cases, 71 (71%) occurred as occupational accidents, mostly seen in workplaces. There was an increase in electrical fatalities in the summer (n = 58, 58%). Accompanying traumatic lesions were detected in 30 (30%) cases. All of the deaths were recorded as accidental except for one suicidal death. Conclusion: The overwhelming majority of electrical fatalities were occupational-related, which were mostly preventable. Proper installation and maintenance of electrical devices will help to tackle electrical injuries at home and in the workplace. Additionally, educational programs for workers and employers should be provided and public and occupational safety measures should be promoted by the authorities. [ABSTRACT FROM AUTHOR]

Aim: We studied the patterns of suicide in forensic autopsies performed in Bursa province of Turkey to determine gender differences, incidence of suicide, subgroups of the population most vulnerable to such deaths, and suicide methods used. Materials and methods: Nine hundred fifty-five death cases due to suicide underwent forensic autopsy between 1996 and 2005 in Bursa were included into the study. All of the cases were analyzed in terms of age, gender, and method of suicide, time of year, and alcohol use. Results were subjected to discriminant analyses using SPSS 11.0. Results: There were 955 cases, with 682 males (12-95 years; mean, 41.2 years) and 273 females (10- 101 years; mean, 33.1 years). For both genders, the most common method was hanging, accounted for 51.6% of the cases. Firearm injuries were more frequent in males than in females while insecticide poisoning, falling from height, and drug poisoning were more commonly used methods in females compared to males (P < 0.001), following hanging. Conclusion: In our study there was a significant difference between men and women in terms of suicide age and suicide method. More research studies are needed on gender differences in suicidal behavior to develop prevention strategies. [ABSTRACT FROM AUTHOR]