Detection of Pneumocystis jirovecii and its DNA in clinically asymptomatic people is defined as colonization. The aim of this study was to reveal the colonization prevalence of P. jirovecii and affecting factors in an immunocompetent population. The study included 200 cases undergoing forensic autopsy between February 2015 and April 2015. The cause of death was non-medical conditions (group 1) in 111 cases (55.5 %), medical conditions (group 2) in 73 cases (36.5 %) and undetermined (group 3) in 16 cases (group 3). Tissue specimens about 1 g in weight were taken from the right upper pulmonary lobe. After DNA extraction, nested PCR targeting mitochondrial large subunit rRNA was used to detect P. jirovecii. Of 200 cases, 37 (18.5 %) had P. jirovecii DNA. There was not a significant difference in place of living, gender, smoking status and medication use between the cases with P. jirovecii and those without P. jirovecii. A significantly high rate of P. jirovecii colonization was detected in group 2 (χ²=7.674; P=0.022). P. jirovecii-colonized cases also had a chronic disease in 2 of 13 (group 1), 12 of 20 (group 2) and 1 of 4 (group 3) cases (χ²=5.571; P=0.062). A significantly high rate of the cases aged 0-1 year had P. jirovecii (5/11; 45.5 %) (χ²=5.639; P=0.018). The results of the study suggest that infants and patients with chronic diseases like cardiac or pulmonary diseases can be at risk for P. jirovecii colonization.
The gender reassignment process has ethical, social and legal dimensions. However, European Union countries have recommended certain principles for such reassignment. The lack of special legislation regulating legal conditions and effects of gender reassignment creates a difficult situation for transsexuals. A new civil law was implemented in 2001 in Turkey recognising gender identity reassignment which has set new standards for procedures. According to the law, court permission is
Multidisipliner bir alan olan adli bilimler, adaletin toplum ve toplumu oluşturan bireyler arasında eşit olarak sağlanabilirliğine hizmet eden sağlık, fen ve sosyal bilimler gibi eğitsel, teknolojik ve pozitif bilimler topluluğunu kapsar. Bu bilimsel alanda teorik ve uygulamanın birbirleriyle örtüşen ve örtüşmeyen birçok noktası bulunmaktadır. Teorik bilgilerin havada uçuştuğu çağımızda bu bilgilerin adli bilimlerin uygulama alanına yansıması çok önemlidir. Adli tıp, hukuk, psikoloji, sosyal hizmet, çocuk gelişimi, kriminoloji, antropoloji, öğretmenlik, medya, polis ve jandarma gibi güvenlik birimlerini de içeren toplumun çok geniş bir alanında birlikte çalışmaya ve üretmeye gereksinim bulunuyor. Eğitim ve öğretimin en önemli parçasını deneyimlerimiz ve uygulama alanları yani “olgu temelli” yaklaşım belirliyor.
Trauma scoring systems are often used for the determination of the severity level of the lesion and the clinical status in medico-legal assessment of the trauma patient. Trauma scoring systems are used also for the determination of the life-threatening conditions. Blood loss of more than 20% was reported as the only criterion for life-threatening conditions in the acute hypovolemia. The objective of this study was to revise the medico-legal assessment criteria in the patients with acute hypovolemia and to discuss other parameters, which might be used in the determination of the severity level of the clinical status.The medical reports of the patients with acute hypovolemia due to the trauma, which were sent by the judicial authorities and by other departments of our medical faculty to the department of the forensic medicine between 1999 and 2009, were evaluated. The characteristics such as age, gender, severity of the injury, type of the trauma, history of liquid replacement or blood transfusion, vital signs, type of the physical injury, injured region of the body, presence of any chronic disease were assessed and recorded.The mean age of the included 155 patients was 34.70 ± 16.08 years (3-87 years). 118 (76%) of patients were males and 37 females (24%). Regarding the event types, road accidents were the most common cause (60.0%) and it was followed by sharp object injuries (18.7%) and firearm injuries (11.6%). 27.7% of the subjects received 2 units blood and blood products transfusion and 21.3% only 1 unit transfusion. According to the results of the medico-legal assessment, 84.5% of the patients had life-threatening conditions.While evaluating the severity of the clinical conditions in the hypovolemic patients, to report only the losses in percentage causes problems and limitations. Therefore, in respect of the medico-legal assessment of the hypovolemic patients, we believe that it would be more appropriate to use the physiological trauma scoring systems (like Revised Trauma Score) instead of the anatomic scoring systems.
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