Artificial prophylactic intraoperative pneumoperitoneum is a simple and safe procedure that decreases the postoperative amount of fluid drainage, residual pleural space, duration of chest tube drainage, and hospital stay.

No abstract

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.

Background/aim: Peripheral blood DNA profiles are often used in forensic identification and paternity investigations. Currently, because of the increasing number of patients who undergo transplantation, determining the history of transplantation has gained importance in forensic cases. The aim of this study was to investigate the potential of genetic chimerism analysis of blood, hair follicle, and buccal swab samples for the forensic identification of transplant patients. Materials and methods: Blood, hair follicle, and buccal swab samples from five patients who had undergone allogeneic peripheral blood stem cell transplantation (allo-PBSCT) and 35 patients who had undergone liver transplantation were analyzed. After isolation of DNA from the samples, specific short tandem repeat sequences were amplified using polymerase chain reaction and genotype was determined using capillary electrophoresis. Results: DNA profiles of the patients were compared. The DNA profiles of blood, hair follicle, and buccal swab samples of four patients who had undergone allo-PBSCT were completely different; there was no mixed chimerism. Conclusion: It is known that after successful allo-PBSCT, DNA profiles of peripheral blood samples show donor chimerism, those of buccal swab samples vary with duration after transplantation, and those of hair follicle samples remain unchanged. Our results were in agreement with these findings.