ADLİ TIP BÜLTENİ

1

Authors: M. hakan Özdemir

Derginizde Hülya Öztürk, Cezmi Karasu tarafından kaleme alınan “Mekteb-i Tıbbiye-i Adliye-i Şahane'nin kurucusu Charles Ambroisse Bernard'ın eserleri ve Osmanlı'ya etkileri üzerine bir değerlendirme” başlıklı yazıyı büyük bir keyifle okudum. Dr. Charles Ambroisse Bernard'ın 6 yıl gibi bir sürede yaptıkları karşısında şaşırmamak, ona saygı duymamak elde değil. Yazıyı okuduğumda ilk aklıma gelen ve yıllardır düşündüğüm “Mekteb'i Tıbbiye'i Adliye'i Şahane” acaba nasıl bir mekandı? sorusu aklıma yine takıldı. 1839 tarihinde Linardi Sokağında (Bugünkü Eski Çiçekçi sokağı) açılan Mekteb-i Tıbbiye-i Adliye-i Şahane, maalesef 11 Ekim 1848 günü çıkan bir yangın sonucu yok olmuştur. Merakımı özel bir koleksiyonda bulunup yayınlanan Mekteb-i Tıbbiye-i Adliye-i Şahane'nin resmi ve verdiği diplomayı görünce giderdim. Bu yazıyı okuyunca resimleri dergi okuyucuları ile paylaşmak istedim. Bu yazının dergide yayınlanmasını sağlayan editöryal kurul üyelerinin ve kaleme alan Hülya Öztürk, Cezmi Karasu'ya bir kez daha teşekkürler.

7-13

Authors: Muharrem Teyin, Yasemin Balcı, Sema Uslu, Kenan Karbeyaz, Kazım Özdamar

Aim: The time of the death has been one of the questions frequently inquired by courts to the forensic medicine experts. In this study, it is aimed to investigate the relationship between cause of death and postmortem interval with can easily be detected in postmortem intraocular fluid samples and routine biochemical tests. Materials and Methods: A total of 100 cases autopsied at the Eskisehir Osmangazi University whose exact times of the death were known has been included in the study. Cases were divided into 3 groups as 10 hour and below postmortem interval, 10-20 hours and upon 20 hours. The cause of death was divided into two groups as traumatic and non-traumatic. Results: In this study the significant relationship was determined between potassium and uric acid levels and postmortem interval. It is determined that the mean level of Sodium and Chlorine sow difference in patients died because of traumatic and non-traumatic reasons. Key words: Postmortem biochemistry, Vitreous humor, Time since death, Cause of death.

21-26

Authors: Burak Kulaksızoğlu, Sibel Kulaksızoğlu, Hamit Yaşar Ellidağ, Necat Yılmaz, Selen Bozkurt

Objective: The aim of this study is to retrospectively analyze the substance use specifications and sociodemographic data of individuals who were brought to the Clinic of Psychiatry of the Antalya Education and Research Hospital. Methods: The recorded files of the individuals in the archives of the probation unit who were referred to our hospital by the Branch Office of the Probation and Help Center (BOPHC) were retrospectively analyzed and the data obtained were recorded in the data form. Results: When the substance use among the individuals presenting to the Antalya Education and Research Hospital in between 2012 and 2014 were analyzed, substance use had increased 82% and 76% between the years 2013 and 2014, respectively. Ninety-seven percent of substance users were male with a 118% and 102% increase in marijuana use in 2013 and 2014, respectively. Morphine use increased by 43% and 42%, respectively. The frequency of substance use in females increased by 52% and 131%, respectively. The mean age of the substance users has decreased in the last three years. Fifty eight percent of the substance users in the year 2014 were single, 74% of them graduated from the secondary school, and 65% were self-employed. Conclusion: Narcotic substance use increased markedly in the last three years in the Antalya region, according to the data obtained in this study. The rate of substance use was higher when compared to the other cities. The most commonly used substance was marijuana. Substance use increased among women. The mean age of the substance users decrease. Only 14% of the substance users desired to be treated. Key Words: drug addiction, probation, Antalya, cannabis

34-37

Authors: Hüseyin Kasap, Taner Akar, Birol Demirel, Ahmet Zahit Dursun, Serhat Sarı, Alper Özkök, Önder Aydemir

Objective: Malpractice is defined as the illness going out of its normal course, delayed healing, death of a patient because of physicians unlawful and/or defective medical practice and treatment. The increase in the both criminal and compensation cases claiming malpractice have led the physicians to practice defensive medicine. Defensive medicine’s reflection to the "Examination for Specialty in Medicine" is that specialties withlower risk are preferred priorly. Materials and Methods: In this research it is aimed to demonstrate the change of preference priorities of specialties by physicians after the risk groups were determined relying on the ’Compulsory Liability Insurance Related to Medical Malpractice’, entered into force in 2010. According to this insurance, the group with the highest risk is 4th and the group with the lowest risk is the 1st. The base points of specialties according to 2009-2013 Examination for Specialty in Medicine (TUS) placement results were included to the research. Results: From 2009 to 2013 it was determined that second group’s base points increased gradually, third group remained stable and the fourth group decreased significantly. Conclusion: We believe that, the reason of the change of the priority of physicians is not only the rise of the violence of which the physicians are subjected to, but also, in spite of the increased number of claims braught and the amount of indemnity due to the higher risk of the medical application faults compared to other groups, the almost steady income of the physicians compared with that risks that take. While it is being discussed that defensive medicine is practiced more often each day, we demonstrated in this research that this situation is even reflected to the preferences of specialist candidates. Keywords: Medical malpractice, Defensive medicine, Examination for specialty in medicine.

43-48

Authors: İlker Koçar, Ökkeş Koçyatağı, Hakan Kar, Nursel Gamsız Bilgin, Halis Dokgöz

Many injuries, even deaths can be seen as a result of the intervention of the security forces to protest demonstration or social events in our country. The right of individual application to medical facilities for their health status and treatment is ensured by constitutional law and international legal regulations. Despite this assurance many problems can occur during forensic reporting process concerned with both medical facilities and judicial authorities. Key words: Social event; Protest demonstration; Injury; Individual application Forensic report.

53-55

Authors: Gülden Çengel, Esra Gürlek Olgun, Semih Alper Kureş, Cafer Uysal, Mehmet Ali Çakmak, İsmail Özgür Can

Spontaneous dissection of coronary arteries is accepted as one of the rare reasons of myocardial infarction. Spontaneous non-traumatic coronary artery dissection occurs rarely. Eosinophilic periarteritis of coronary artery may cause coronary artery dissection. Coronary eosinophilic periarteritis is put forward as predisposing factor of intimai impairment and dissection. In the literature; 1/3 of women with eosinophilic periarteritis is pregnant or in postpartum stage. In our case, 35 aged postpartum woman, who was deteriorated at home is brought hospital as dead. In the histopathological examination of tissue samples taken by the autopsy, made in The Council of Forensic Medicine, dissection in the left descending branch of coronary artery related to eosinophilic periarteritis and thyroiditis in the thyroid tissue samples is observed. In the literature, there is a few death case, related eosinophilic periarteritis with, autoimmune thyroiditis. It is found important because of that it i s one of the pathologies, which must come to mind firstly in postpartum period women deaths. Keywords: Postpartum, Arteritis, Eosinophilic, Coronary, Dissection.

60-70

Authors: Oğuz Polat

Pedophilia is a deviant sexual behavior which is a sub-category of paraphilias. If acted out, pedophilia is legally defined as sexual child abuse. Pedophilia includes fondling a child's genitals, intercourse, rape, sodomy, exhibitionism, and commercial exploitation of children through prostitution or the production of pornographic materials. Pedophiles who have sexually abused children require intense psychological and pharmacological therapy prior to release into the community because of the high rate of repeat offenders. The incidence of pedophilia has been markedly underestimated. It is often discussed whether sexual offenders of children are pedophiles or child molesters. It depends on exact definition and operationalizational categorization .Practical question from forensic point of view is whether there are any differences between the group of 'pedophiles', who have sexually offended child and the group of child molesters, who do not meet criteria for pedophilia. It confirms the opinion that not all of child sexual offenders are pedophiles. Regarding pedophilia remains the problem of its definition in conditions of practical acceptance. Keywords: Pedophilia, Child sexual abuse, paraphilia