Mustafa Talip Sener

Biochemical and histologic study of lethal cisplatin nephrotoxicity prevention by mirtazapine

BACKGROUND Cisplatin is a platinum derivative frequently used in the chemotherapy of different solid tumors. This biochemical and histologic study investigated a possible protective effect of mirtazapine with regard to cisplatin-induced nephrotoxicity in the rat. METHODS The animals were divided into 4 groups: 15 mg/kg mirtazapine + 10 mg/kg cisplatin, 30 mg/kg mirtazapine + 10 mg/kg cisplatin, only 10 mg/kg cisplatin and negative control (healthy) group. During 14 days, the treatment and treated control group took drugs, while the healthy animals were given distilled water on the same schedule. All animals were sacrificed by high-dose anesthesia at the end of the 14 days of treatment; their kidneys were removed and subjected to histologic and biochemical study. RESULTS In both of the doses we used, mirtazapine decreased the levels of malondialdehyde, creatinine, blood urea nitrogen and myeloperoxidase activity when compared to cisplatin group. On the other hand, it increased total glutathione level in all doses. Slight histopathological findings were determined in mirtazapine groups when compared to cisplatin control group. CONCLUSION In the light of our results and literature knowledge, we can conclude that the protective effect of mirtazapine in cisplatin toxicity originates from its own antioxidant activity.

Paintball-related ocular trauma: paintball or painball?

Background The aim of this study is to describe the type and severity of paintball-related ocular trauma and to determine the necessary precautions to minimize the risk of ocular injury regardless of whether adequate eye protection was used. Material/Methods A retrospective chart review identified patients treated for paintball-related ocular trauma at the Ataturk University Medical Hospital from June 2010 through March 2013. A descriptive analysis of data was performed. Results Ten patients with paintball-related ocular trauma were identified. At the time of their first examination, 7 of these patients had visual acuity (VA) of 20/200 or worse. One patient had a final VA of no light perception and 4 patients had a final VA of 20/200 or worse. Hyphema was noted in 7 patients, traumatic cataract in 2, iridodialysis in 2, retinal detachment in 3, and secondary glaucoma in 1. Six patients required surgery. Although all victims have used eye protection during the game, all patients were injured after they thought the game was over and had taken off their helmets or eye-protective devices. Conclusions Paintball-related accidents result in serious ocular trauma and most of the patients require surgery. These injuries result in severe loss of VA in some patients. Uninterrupted use of proper eye protection whenever a player is in the game field, even after they believe the game has ended, may reduce the incidence of severe ocular trauma in paintball players.

Does working with child abuse cases affect professionals' parenting and the psychological well-being of their children?

Work in the field of sexual abuse is extremely stressful and may arouse negative personal reactions. Although these secondary trauma effects are well described on a personal level, there is not enough evidence to understand whether these professionals carry these effects to their homes, families, and offspring. This study aims to identify the effects of working with child abuse cases on the anxiety level and parenting styles of childhood trauma workers and on their children’s well-being. A total of 43 health and legal system workers who worked with abused children in any step of their process and who had children constituted the study group, and 50 control cases, each working in the same institution and having the same occupation as 1 of the participants from the study group and having children but not working directly with children and child abuse cases, were included in the study. Participants were asked to fill out a sociodemographic form, the Parental Attitude Research Instrument, the trait portion of the State-Trait Anxiety Inventory, and an age-appropriate form of the Child Behavior Checklist for each child they had. Professionals in the study working with child abuse cases demonstrated significantly higher democratic parenting attitudes. Law enforcement workers working with child abuse cases demonstrated stricter and more authoritarian parenting strategies, as well as more democratic attitudes, than their colleagues. There was not a statistically significant relationship between child abuse workers’ anxiety level and their children’s well-being among control subjects.

Bullet Migration from Fascial Space of Femoral Vein to Common Iliac Vein Bifurcation

Introduction: Migration of a retained bullet in the body is rare. Some studies have reported regarding embolism induced by intravascular bullet migration. Here we present a case of lead bullet migration through the external surface of the right femoral vein. Case Report: A 31-year-old male was referred to our department for clinical forensic medical evaluation. He was assaulted while working at his office and thus was subsequently taken to the emergency department. Physical examination revealed that the bullet first entered from the left thigh and passed through the medial part of the right thigh with its own kinetic energy, and after 7 h, it passively moved up to the common iliac vein via the femoral space of the right femoral vein. Conclusion: This case report is important as it demonstrated that the lead bullet retained in the body may have passively migrated toward proximal and abdomen via the external surface of the vein between the fascia and intermuscular structures

How will amendments in crimes against sexual privacy and failure to evaluate the mental health of the victims will affect them? [Cinsel dokunulmazliga karsi suclarda yapilan kanun degisikligi ile ruh sagliginin degerlendirilmemesinin magdurlara etkisi ne olacak?]

The concepts of physical or mental health were removed from the articles regulating the crimes against sexual immunity in the Turkish Penal Code. Today, judicial authorities don’t require forensic medical evaluation of physical or mental health of the victims. In this study, it is aimed to investigate the effect of the amendment on psychiatric examinations in the forensic medical examination of victims of sexual crimes. The data of 292 cases, who were evaluated by a committee established in accordance with 7th, 23rd and 31st Articles of Institute of Forensic Medicine Act between January 1, 2012 and July 30, 2015 at Ataturk University Faculty of Medicine to see if there is any negativities in the physical or mental health of the victims, were reviewed retrospectively. In these evaluations, psychopathology was identified in 58.6% (n=171) of the cases due to sexual trauma. Before the evaluation of the committee, the judicial authorities asked for both physical and mental results of sexual trauma of 62.6% (n=183) of the cases and psychiatric results of sexual trauma of 37.4% (n=109) of the cases as part of the forensic medical assessment. The psychiatric examination of these 109 cases was done by this committee for the first time and psychopathology was identified in 56.9% (n=62) of these cases due to sexual trauma. Psychiatric examination of victims of sexual crimes is a medical obligation independent from the legal process. Although the law changes, forensic medical examination of the victims should be done to include psychiatric examinations with a multidisciplinary approach.

Factors affecting adherence to treatment and follow-up of burns in children: A single centre experience.

Aim: Children are prone to burn injury. Burns can be seen as a part of child abuse. The aim of this study was to investigate the factors affecting adherence to the treatment of burn patients, and to emphasize the role of the physician in identifying childrens non-accidental burn injuries. Materials and Methods: Children who were hospitalized in the burn unit were analyzed retrospectively. Results were assessed for significance using the Chi-square test. Results: A total of 189 patients were included. Some patients (n = 52; 27.5%) were discharged against medical advice (DAMA) before completion of treatment. Although we could not demonstrate a relationship between non-accidental etiology and DAMA group, it was significant that these patients did not contact the outpatient clinic after discharge. It was evident from records that two of these cases were abused. The reasoning of the parents in the DAMA group for the early discharge was siblings at home, financial and accommodation problems. Conclusion: Although burns in children commonly occur due to an accident, each burn case should be examined for a non-accidental etiology and findings suggesting abuse should be noted. Physicians should be alert for the detection of signs of burn related child abuse.

How valuable is P-wave dispersion in the determination of carboxyhemoglobin levels?

Objective: To determine whether or not wave/interval dispersions in electrocardiography (ECG) are increased, and to define whether wave and interval dispersions are correlated with carboxyhemoglobin (COHb) levels. Methods: ECG, complete blood count, and biochemical parameters were taken from 87 patients with carbon monoxide (CO) poisoning as well as 90 control patients with similar age, gender, and body mass index distribution. COHb levels were recorded in CO-poisoning patients. The COHb levels and the relationships with ECG parameters were studied. Results: Pmax, Pmin, Pd, PRmax, PRmin, PRd, QTmax, QTmin, QTd, cQTmax, cQTmin, cQTd, Tmax, Tmin, and Td in ECG were higher in intoxicated patients than the control group (p < 0.05 for all). Pearson’s correlation analyses showed moderately significant positive correlations between COHb level and Pmax (r = 0.224; p = 0.037) and Pd (r = 0.222; p = 0.039). The receiver–operator characteristic (ROC) curve showed that a Pd value of 38 ms determined by ECG separates patients with a COHb ≥ 20% with area under the ROC curve of 0.78 (95%CI = 0.71–0.83), a sensitivity of 67.9% (95%CI = 59.4–75.6), a specificity of 95% (95%CI = 83.0–99.2], a positive predictive value of 97.9% (95%CI = 92.5–99.7), and a negative predictive value of 46.3% (95%CI = 35.3–57.7.) Conclusion: A significant increase in wave/interval dispersions in the ECG of CO-poisoning patients compared with controls may show that not only a part is affected but both atrium and the ventricles as a whole are affected by hypoxic ischemia. When COHb levels of the patients are unavailable, P dispersion on ECG may show CO poisoning level of the patient.

Adli Psikiyatri Değerlendirme İstemlerinde Adli Mercilerin Branş Tercihleri : Bir Üniversite Hastanesi Deneyimi

Area of specialty preferences of forensic authorities in forensic psychiatric evaluation requests: a university hospital experience Objective: In this study, we aimed to find the relevant factors of forensic medicine, child and adolescent psychiatry, and psychiatry fields’ preferences in the forensic psychiatric assessment requests of forensic authorities. Method: Case records which are consulted to Erzurum Ataturk University Faculty of Medicine, Forensic Medicine, Child and Adolescent Psychiatry, and Psychiatry Departments between 01.01.2010 and 31.12.2010 were assessed retrospectively. Results: Of the 330 cases who were assessed, 54.2% (n=179) were male, 45.8% (n=151) were female, 54.8% were (n=181) child and adolescent, and 45.2% (n=149) were adult. In the light of our results, forensic authorities noticed the difference of choice between forensic medicine and child and adolescent psychiatry when consulting child and adolescent cases. Besides there was no difference for the choice between forensic medicine and psychiatry in the forensic psychiatric evaluation of adult cases. Discussion: It is thought that interdisciplinary approach which was formed by developing law practices of specialty area choice in the forensic psychiatric evaluation requests of forensic authorities is an important step for achieving accurate results. Conclusion: Evaluations in the area of forensic psychiatry should be made with cooperation of related disciplines.