Background The use of more than one potentially lethal method together and sequentially to complete suicide is called “complex suicide.” Complex suicides are divided into two groups: planned and unplanned. This study aimed to discuss with literature 21 complex suicide cases identified after a 2-year retrospective study. Results This study included 21 complex suicide cases. Eleven were classified as planned complex suicides, and 10 were labeled as unplanned complex suicides. The average age of all cases was 42.5 ± 17.7 (min: 19, max: 76) years. Suicide notes were present in six (28.5%) cases. Fifteen victims (71.4%) suffered from psychiatric diseases. Twelve victims ingested a toxic dose of medication, nine cases jumped from a height, eight cases used stabbing, six cases used hanging, two cases ingested a corrosive substance, two cases drowned, two cases inhaled a toxic gas, one case ingested cyanide, one case ingested insecticide, and one case used suffocation with a plastic bag. In two cases, three methods of suicide were used together. In the current study, “corrosive substance intake + cyanide intoxication” and “corrosive substance intake + jumping from a height” were defined for the first time and have not been previously described in the literature. Conclusions Complex suicides are highly likely to be potentially mistaken for murder. The cause of death in these cases can be determined with a comprehensive autopsy along with a detailed examination of the scene, statements of relatives, and eyewitnesses.

Aim: This study aimed to present 96 cases evaluated by the 1st Specialization Committee of The Council of Forensic Medicine, which included medical malpractice claims about urologists resulting in death between 2010 and 2015 and to increase the awareness of urologists about medical malpractice claims. Materials and methods: The reports prepared by the 1st Specialization Committee of The Council of Forensic Medicine between 2010–2015 were reviewed retrospectively. All of the cases treated in Urology clinics, alleged medical malpractice, and resulted in death, participated in the study. Results: In this study, 96 cases were included. It was reported that there was medical malpractice in 16 (16.7%) cases. Seventy–six of the patients (79.2%) were female; the most common age range was ≥ 60 years (n:46 47.9%); the mean age was 54,90±19,59 years. Seventy–three (76%) cases were followed up under elective conditions. Complications developed in 20 (20.8%) of the cases during their treatment course. Surgical treatment was applied in 68 (70.8%) patients. Twenty (20.8%) cases were diagnosed with urinary system stone disease and 16 (16.7%) cases with benign prostatic hyperplasia. The committee attributed malpractice to the doctors most frequently due to lack of treatment (n:6, 37.5%). Conclusion: We think that a comprehensive review of the cases with medical malpractice claims will contribute to a better understanding of these cases, the improvement of the medical service provided, and public health.

GIRIŞDünya Sağlık Örgütü'ne (DSÖ) göre "65 yaş ve üzeri" insanlar yaşlı olarak kabul edilmektedir. Yaşlı nüfus kendi içinde; 65-74 yaş grubu "genç yaşlı", 75-84 yaş grubu "yaşlı" ve "85 yaş ve üze-ri" ileri yaşlı olarak üç alt gruba ayrılmaktadır (1). Küresel olarak nüfus yaşlanmakta ve 65 yaş üzeri kişiler birçok ülkede intihara en yatkın grup olarak görülmektedir (2). Ülkemizde yaşlı nüfu-sun tüm nüfusa oranı 1970 yılında %4,4 iken, 2015 yılında bu oran %8,2 olmuştur (3). Ülke-mizde 2006 yılında gerçekleşen tüm intiharların %8,7'si 65 yaş ve üzeri olgular iken, bu oran 2015 yılında %11,7'ye yükselmiştir (4). Bu veriler; gü-nümüzde üzerinde çok durulmayan yaşlı intiharlarının, eğer gerekli tedbirler alınmazsa, gelecekte ciddi bir sağlık sorununa dönüşebileceğini göstermektedir.Bolu Adli Tıp Şube Müdürlüğü'nde 2016 yılı içe-risinde otopsisi yapılan üç yaşlı intihar olgusu sunularak, literatür eşliğinde tartışılması amaç-lanmaktadır. OLGU 1İlk olgumuz 77 yaşında bir erkektir. Yakınlarının ifadesinde; köyde oğlu ve gelini ile birlikte yaşadığı, içine kapanık bir insan olduğu, son zamanlarda içine daha da kapandığı belirtilmiştir. Olay günü tarlada çalışan olgunun öğlen vakti oğlunu yemek yemesi için eve yolladığı, kendisi- Çalışmada üç yaşlı intiharı olgusunun sunularak yaşlılarda intihara götüren nedenlerin ve buna yönelik olarak alınabilecek önlemlerin tartışılması amaçlanmaktadır.Sonuç olarak yaşlılara verilecek sosyal ve psikolojik desteğin, intihar oranının azalmasına katkı sağlayacağını düşünmekteyiz.Anahtar Kelimeler: Yaşlı intiharları, yaşlı intiharlarındaki risk faktörleri, intihar yöntemleri, ası, ateşli silah. ABSTRACTAs in the whole world, the proportion of elderly population in Turkey is increasing rapidly, In parallel, the rate of suicides seen in the elderly is also steadily increasing. Losing their spouses and relatives, living alone, physical and psychiatric diseases, economic problems, loss of social status are the risk factors for suicide in elderly adults. In present, elderly suicides are emerging as a serious public health problem. In our country, hanging and firearms are the most frequently suicide methods in the elderly group.It is aimed to discuss the causes of suicide in the elderly and the precautions that can be taken against it by presenting the case of three elderly suicide in the study.As a result; we think that the social and psychological support given to the elderly will contribute to the decrease of suicide rate.

BACKGROUND: This study was aimed to evaluate the injury characteristics, causes, results, and hospital charges in cases of occupational accidents that were reported to judicial authorities using trauma scores. METHODS: The study was performed after obtaining permission from the judicial authorities and approval from the local ethics committee. All occupational accident cases that were reported to the judicial authorities in Bolu Province between 2015 and 2019 were included in the study. The groups were compared with the Chi-Square test, Mann-Whitney U Test, and the Kruskal-Wallis Test. P<0.05 was considered statistically significant. RESULTS: This study included 3599 cases. The majority of the cases (74.70%) were male, with a mean age of 34.90±10.50 years. Occupational accidents occurred most frequently between 8 and 16 h (n=1982; 55.10%), on Friday (n=595, 16.53%), in April (n=356; 9.89%), and in spring (n=971; 26.98%). Occupational accident-related death occurred in 29 cases (0.8%). The most common injury due to occupational accidents occurred in the food industry (n=1256, 34.90%). Blunt object injury (n=1112, 30.90%) was the most common type of occupational accident; and the upper extremity (n=2049, 54.93%) was the most common injury localization. The mean Abbreviated Injury Scale of the cases was 0.94±0.74, the mean Injury Severity Score (ISS) was 1.79±4.47, and the mean New-Injury Severity Score (NISS) was 2.11±5.28. The means of ISS and NISS were statistically significantly higher for males, life-threatening injuries, work accidents in the Construction and Agriculture-Forestry sectors, fall from height, traffic accidents, and caught-in-machinery. The total hospital charge was 1,351,339.10 TL and its average was 380.30±2418.90 TL. The mean of treatment costs was significantly higher in the agriculture-forestry and construction sectors. CONCLUSION: The evaluation of all occupational accidents that are submitted to the jurisdiction on a provincial basis may provide more useful information in the prevention of work accidents. The use of trauma scores in the evaluation of occupational accidents is a useful argument for understanding the sectors and injury types that cause severe trauma. Furthermore, trauma scores may be an important predictor of hospital costs.

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