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Öğe 2000-2005 yılları arasında Düzce Tıp Fakültesi Adli Tıp Anabilim Dalına başvuran cinsel saldırı olgularının muayene süreçlerinin değerlendirilmesi(2008) Büken, Bora; Büken, Erhan; Erkol, Zerrin2000 - 2005 yılları arasında Düzce Tıp Fakültesi Adli Tıp Anabilim Dalı’na cinsel saldırı iddiası ile başvuran olgular retrospektif olarak incelendi. Toplam 53 olgunun 44’ ünün ( %83,1) kadın olduğu saptandı. Mağdurların 03-39 (ortalama 17,11 ± 6,74) yaş arasında, saldırganların ise 17-56 (ortalama 27,09 ± 11,24) yaş aralığında bulunduğu görüldü. %47,2 olgu bir kez cinsel saldırıya maruz kaldığını belirtirken, %39,6 olgu cinsel saldırının 5’den fazla sayıda gerçekleştiğini beyan etmişti. Saldırganlardan 23’ü (%43,4) tanıdık, 7’si (%13,2) daha önceki sevgili, 4’ü (%7,5) baba ve 4’ü (%7,5) yakın erkek akraba olup, 6 (%11,3) olgu eşleri tarafından istemedikleri şekilde cinsel ilişkiye zorlandıklarını belirtmişlerdi. Olguların 34 (%64,15)’ünün ilk başvuru yeri Cumhuriyet Savcılığı olup, sadece 2 (%3,77) olgu ilk olarak hastaneye başvurmuştu. Mağdurların 11’i (%20,8) ilk 24 saat, 4’ü (% 5,7) ilk 72 saat içinde şikayetleri sonucu ilk muayeneye alınmışlardı. 7 olguda “Akut Stres Bozukluğu” ve olaydan 6 ay sonra yeniden muayeneye gönderilen 10 olguda “Trav-ma Sonrası Stres Bozukluğu” (TSSB) tanısı konmuş, 6 olguda aşağı debilite düzeyinde zeka geriliği saptanmıştı.Öğe Ateşli silahların adolesans döneminde stres yapıcı faktör olarak etkisi(2009) Büken, Bora; Erkol, Zerrin; Bahçebaşı, Talat; Büken, Erhan; Özdinçer, SevdaAmaç: Çalışmada ateşli silah ile temas etmiş lise öğrencilerinin davranışlarının ve karıştıkları/tanık oldukları ateşli silahla gerçekleştirilmiş şiddet olaylarının incelenmesi ve ateşli silah ile temasın stress arttırıcı bir faktör olup olmadığının araştırılması amaçlandı. Yöntem: Çalışma, ateşli silah kullanımı yaygın olan Düzce ilinde yapıldı. Öğrencilerin ateşli silah edinme yönündeki tutum ve davranışlarının, ateşli silahlar ile gerçekleştirilen şiddet olayları hakkındaki görüşlerinin, kendilerinin ateşli silah ile direkt olarak yüz yüze gelip gelmediğinin ve ateşli silah ile gerçekleştirilmiş şiddet eylemlerine tanık olup olmadıklarının sorgulanmasına yönelik sorular içeren bir anket hazırlandı. Ankete ?stres düzey ölçeği? eklendikten sonra, Düzce'de okuyan toplam 8304 lise öğrencisi arasından rastlantısal yöntemle seçilen 791 öğrenciye uygulandı. Sonuçlar, SPSS 11.0 veri tabanı kullanılarak değerlendirildi. Bulgular: Ateşli silahlarla temas eden öğrencilerin bir şiddet olayı ile karşılaşsın veya karşılaşmasın stres düzeylerinin uyum güçlüğü düzeyine ulaşabildiği; stres düzeyi üzerinde akran grupları ve kardeşler arasında kabadayılık niteliğindeki agresif davranışların etkin olduğu; şiddet olaylarına maruz kalma ve tanıklık deneyimlerinin stres düzeyi üzerinde önemli rol oynadığı; stres düzeyi üzerinde cinsiyet, gelir düzeyi ve evde kendine ait bir oda bulunmamasının da rolü bulunduğu saptandı. Beklenenin aksine evde veya çevresinde ateşli silah bulunmasının, ateşli silahla temas olmadıkça ergenlik dönemindeki gençlerin stres düzeyi üzerinde etkisinin olmadığı, çevrelerinde silah seslerinin duyulmasının stres düzeyi üzerine en etkili faktörlerden olduğu belirlendi. Sonuç: Ergenlik döneminde, strese yol açan ateşli silahlar ile temasın ve bölgemizde yaygın olan silah atma eylemlerinin önlenmesi gerektiği düşünülmektedir.Öğe Comparison of the three age estimation methods: Which is more reliable for Turkish children?(Elsevier Ireland Ltd, 2009) Büken, Bora; Erzengin, Ömer Utku; Büken, Erhan; Şafak, Alp Alper; Yazıcı, Burhan; Erkol, ZerrinBackground: Three atlases-the GOK, the Greulich-Pyle (GP), and the Tanner-Whitehouse (TW3)-are used frequently for age determination in Turkey, The purpose of this study was to evaluate the applicability of these three methods related to the skeletal age assessment for Turkish adolescents. Materials and methods: The conventional roentgenograms of the left hands and wrists, elbows. shoulders, and pelvises of 333 healthy Caucasian children (164 females, 169 males) who fit the study and the criteria of each atlas were obtained. The mean differences (+/- standard deviation [S.D.] in years) between the chronologic age (CA) and the skeletal age (BA), which were obtained by using each age estimation method, were calculated and tested using t-test. Results: For girls, the most accurate method was the TW3 (mean differences (d): -0.21 (p < 0.05)). following by the GP (d: 0.66 (p < 0.001), and the GOK (d: 2.99 (p < 0.001)). For boys, the most accurate method was the GP (d: 0.02 (p > 0.05)), followed by the TW3 (d: 0.18 (p < 0.05)) and GOK (d: 1.05 (p < 0.001)). Discussion and conclusions: Results show that the TW3 (for girls) and the GP (for boys) methods are more appropriate than the GOK atlas for estimating the BA. GOK could be used for boys aged 11-14 years but it should not be used for girls. (c) 2008 Elsevier Ireland Ltd. All rights reserved.Öğe The effect of firearms in inducing stress in high school students in the city of Duzce (Turkey)(Türkiye Sinir Ve Ruh Sağlığı Derneği - Turkish Association of Nervous and Mental Health, 2009) Büken, Bora; Erkol, Zerrin; Bahçebaşı, Talat; Büken, Erhan; Özdinçer, Sevda; Ercan, NadireThe Effect of Firearms in Inducing Stress in High School Students in the City of Dune (Turkey) Objective: This study aimed to examine the behaviors of high school students exposed to firearms and firearms-related violence, which they had perpetrated or witnessed, and whether or not these events were related to stress. Method: The study was conducted in Duzce province, which is characterised by the widespread use of firearms. A questionnaire was prepared to ascertain students' attitudes and behaviors towards owning firearms, their thoughts about firearms-related violence, and whether or not they had been a victim or witness to firearms-related violence. After a stress level scale was added to the questionnaire, it was administered to 791 students randomly chosen from the 8304 students that were attending all high schools in Duzce. The results were evaluated with using SPSS v.11.0 software. Results: The level of stress in students that had contact with firearms, whether or not they were faced with a violent act, may be reached the adaptation difficulty level. Aggressive behaviors like hectoring occurred between coequal groups and brothers/sisters, affectedstress levels. Exposure to and witnessing violent acts had important roles on level of stress. Gender, income level, and lack of a private room at home for adolescents affected stress levels. Contrary to expectations, the presence of firearms at home or in their surroundings did not have an effect on stress levels. Hearing the sound of gunfire was one of the most important factors related to stress levels. Conclusion: Because of its ability to induce stress in adolescents, they must be protected form exposure firearms and their use, which is widespread in Duzce.Öğe Is the "Gök Atlas" sufficiently reliable for forensic age determination of Turkish children?(2008) Büken, Bora; Büken, Erhan; Şafak, Alp Alper; Yazici, Burhan; Erkol, Zerrin; Mayda, Atilla SenihAim: We investigated whether the contemporary use of the Gök Atlas method is sufficiently reliable for forensic age estimations of Turkish children. Materials and Methods: Plain radiographs of 248 females and 298 males between 11 and 22 years of age were taken. Paired sample t-tests, Pearson correlation coefficients, and linear regression were used to determine the differences and model the relationships between mean skeletal (bone) age (BA) and mean chronological age (CA), using SPSS 11.5 statistical software. Results: In all cases, the CA and BA scores were significantly different and showed high correlation (P < 0.05). The regression model was significant (P < 0.01). According to age groups, the BA was greater than the CA for all age groups by 0.09-3.10 years for boys and 0.44-3.05 years for girls, and this difference was significant for all age groups >14 years for boys and for those 11-18 years of age for girls. The standard deviation of the difference between BA and CA for boys between 11 and 18 years of age and for girls between 11 and 20 years of age was >1 year. Conclusions: We found a large discrepancy between CA and BA according to the Gök Atlas. This discrepancy may be significantly misleading, especially in criminal liability cases. © TÜBİTAK.Öğe Is the Tanner–Whitehouse (TW3) method sufficiently reliable for forensic age determination of Turkish children?(2010) Büken, Bora; Şafak, Alp Alper; Büken, Erhan; Yazıcı, Burhan; Erkol, Zerrin; Erzengin, Ömer UtkuAim: The purpose of our study was to determine the accuracy of Tanner-Whitehouse 3 (TW3-RUS) bone age (BA) assessments for forensic age estimations of Turkish children. Materials and methods: Plain radiographs of left hands and wrists of 324 children were evaluated. Mean chronological age (CA) was compared with mean bone age (BA) according to the TW3 atlas for each sex, and differences by age group were determined. Pearson correlation coefficients and cubic regression were used to determine the differences and model the relationships between mean BA and CA. Statistical analyses were carried out using R-project. Results: The difference between the mean CA and the mean BA was statistically significant, and there was a high correlation between them for both sexes. No P values were statistically significant for any age group for girls but P values were statistically significant at 13 and 14 years for boys. The dispersion formula was determined for each sex. Conclusion: We propose that this atlas can be used for Turkish children, until a new atlas that has been distributed and formed according to the results of multiple studies made throughout the country.Öğe Is the “Gök Atlas” sufficiently reliable for forensic age determination of Turkish children?(2008) Büken, Bora; Büken, Erhan; Şafak, Alp Alper; Yazıcı, Burhan; Erkol, ZerrinAim: We investigated whether the contemporary use of the Gök Atlas method is sufficiently reliable for forensic age estimations of Turkish children. Materials and Methods: Plain radiographs of 248 females and 298 males between 11 and 22 years of age were taken. Paired sample t-tests, Pearson correlation coefficients, and linear regression were used to determine the differences and model the relationships between mean skeletal (bone) age (BA) and mean chronological age (CA), using SPSS 11.5 statistical software. Results: In all cases, the CA and BA scores were significantly different and showed high correlation (P < 0.05). The regression model was significant (P < 0.01). According to age groups, the BA was greater than the CA for all age groups by 0.09–3.10 years for boys and 0.44-3.05 years for girls, and this difference was significant for all age groups >14 years for boys and for those 11-18 years of age for girls. The standard deviation of the difference between BA and CA for boys between 11 and 18 years of age and for girls between 11 and 20 years of age was >1 year. Conclusions: We found a large discrepancy between CA and BA according to the Gök Atlas. This discrepancy may be significantly misleading, especially in criminal liability cases.Öğe Obstetric and gynecologic malpractice in Turkey: Incidence, impact, causes and prevention(2004) Büken, Erhan; Örnek, Büken Nuket; Büken, BoraThe Forensic Medicine Association was established in Turkey by law number 2659 for the purpose of providing expertise in legal cases. In this study the opinions given by the lawcourts and public defenders in the Forensic Medicine Association's First, Second, Third, and Fifth Specialization Divisions between the years 1990 and 2000 (approximately 680,000 files) were examined retrospectively. It was determined from these that there were 636 cases of medical malpractice. In examining the distribution of cases based on speciality branch, it was established that 16.82% (n=107) were in the area of obstetrics and gynecology, 10.69% (n=68) in general surgery, 10.53% in neurology and neurosurgery, and the remaining areas were found to be at lower percentages. It also showed that in recent years there has been an increase in the number of cases claiming medical malpractice in the area of obstetrics and gynecology, and that 58% of the cases (n=62) from 1998 to 2000 were in this area. 96% of the 107 cases that claimed malpractice in the area of obstetrics and gynecology were found to be related to obstetrics and 3.8% (n=4) to gynecology and surgical procedures. In 31% (n=33) of the 107 cases fault was found; all of the cases where medical malpractice was found were in the area of obstetrics and none of the cases related to gynecology were found to have an element of error. Cases that had an element of error were evaluated from the aspect of profession of the health care personnel at fault, areas of fault, places where fault occurred, situations that resulted in death, cause of death, whether or not an autopsy was done, injury that resulted from fault, intervention that was done, and obstetric and gynecologic risk factors that set the stage for claims. Care standards and breach of standards were examined. © 2003 Elsevier Ltd. All rights reserved.Öğe Ölümle sonuçlanan diagnostik jinekolojik laparoskopi: Hekim kusurlu mu?(2005) Büken, Bora; Demiraran, Yavuz; Büken, Erhan; Kocaman, BuketTıbbi uygulama hatası iddiası tıbbın bütün alanlarını ilgilendirmektedir. Meydana gelen her kötü sonuç bir tıbbi hatadan kaynaklanmaz. Son yıllarda ülkemizde bir çok cerrahi girişimde laparoskopik cihazların kullanımı rutin olarak, yaygın bir şekilde kullanılmaya başlamıştır. Bu nedenle işlemin potensiyel riskleri ve komplikasyonları da göz ardı edilmemelidir. Çok nadir görülen komplikasyonlar bazen çok ciddi, hatta öldürücü olabilmektedir. Bu olgu sunumu endometriosis problemi olan 30 yaşındaki bir bayanda tanısal amaçlı karbondioksit insüflasyonu kullanılarak yapılan diagnostik laparoskopi sırasında ani gelişen kardiovasküler kollaps sonucu ölüm ve tıbbi uygulama hatası iddiasını içermektedir.Öğe Risk factor in victims of sexual assaults who acquaınted, and met with their perpetrators via social networking services(Nobel İlaç, 2014) Büken, Bora; Erkol, Zehra Zerrin; Kandemir, Ferhan; Büken, ErhanObjective: In this study, our aim was to analyze the cases who had been exposed to sexual abuse by the individuals whom the internet user was acquainted with via social networks, and met them outdoors with the intention to distract attention to the potential dangers of social networks, and also discuss possible measures to be taken to ensure safe use of internet. Material and Method: For this purpose, 13 out of 162 cases who had been referred to the Department of Forensic Medicine, between the years 2011, and 2013 with a history of exposure to sexual abuse by the perpetrators whom they had gotten in personal contact after their acquaintance via internet were included in the study. Results: All of victims were female and perpetrators were male. Mean age of the cases was 17.00 +/- 2.3 years. Only one case was in the age group of >= 19 years. Sexual assault was claimed to be perpetrated via vaginal (n=4), anal (n=3), both vaginal, and anal (n=3) penetrations, while in three cases, any incident of penetration was not alleged. Physical examination revealed evidence of vaginal (n=3), anal (n=3) or both vaginal, and anal (n=1) penetrations. Conclusion: It is not completely possible to prevent children from exposure to harmful environment, and behaviours encountered on-line, so we think that necessary accumulation of information about harmful internet content, and educational courses on effective protection from its adverse effects will be beneficial.Öğe Risk factors in victims of sexual assaults who acquainted, and met with their perpetrators via social networking services(Nobelmedicus, 2014) Büken, Bora; Erkol, Zerrin; Kandemir, Ferhan; Büken, ErhanObjective: In this study, our aim was to analyze the cases who had been exposed to sexual abuse by the individuals whom the internet user was acquainted with via social networks, and met them outdoors with the intention to distract attention to the potential dangers of social networks, and also discuss possible measures to be taken to ensure safe use of internet.; Material and Method: For this purpose, 13 out of 162 cases who had been referred to the Department of Forensic Medicine, between the years 2011, and 2013 with a history of exposure to sexual abuse by the perpetrators whom they had gotten in personal contact after their acquaintance via internet were included in the study.; Results: All of victims were female and perpetrators were male. Mean age of the cases was 17.00±2.3 years. Only one case was in the age group of ?19 years. Sexual assault was claimed to be perpetrated via vaginal (n=4), anal (n=3), both vaginal, and anal (n=3) penetrations, while in three cases, any incident of penetration was not alleged. Physical examination revealed evidence of vaginal (n=3), anal (n=3) or both vaginal, and anal (n=1) penetrations.; Conclusion: It is not completely possible to prevent children from exposure to harmful environment, and behaviours encountered on-line, so we think that necessary accumulation of information about harmful internet content, and educational courses on effective protection from its adverse effects will be beneficial. © 2014, Nobelmedicus. All rights reserved.Öğe Trafik kazalarında sürücünün belirlenmesinde adli tıbbi muayenenin rolü: Olgu sunumu(2007) Büken, Bora; Büken, Erhan; Erkol, ZerrinTrafik kazalarının nasıl meydana geldiğine yönelik bilirkişi çalışmaları yapılmaktadır. Taşıt içi yaralanma ve ölüm olgularında önemli bir sorun da kaza sırasında taşıt içindekilerin konumlarının değişmesi ile sürücünün belirlenmesinde ortaya çıkan güçlüklerdir. Yazıda, kaza sırasında araçta bulunan bir başka kişinin taşıtı kullandığının iddia edildiği, ancak yapılan adli tıbbi inceleme sonucunda olay sırasında taşıtı kullanması daha muhtemel olan kişinin belirlendiği bir trafik kazası olgusu sunulmuştur. Yargılama sürecinde söz konusu kişinin kaza sırasında aracı kullandığını itiraf etmesi ile bu görüş desteklenmiş ve adli değerlendirme sürecine katkıda bulunulmuştur. Bu olgu sunumu ile trafik kazalarında; güvenlik güçleri, adli makamlar, adli tıp ve adli bilimler uzmanlarının etkin şekilde yapacakları ortak çalışmaların, sonradan çıkabilecek olası adli sorunların önlenmesinde önemli bir katkı sağlayabileceğinin bir kez daha vurgulanması amaçlanmıştır.Öğe When did the trauma happen: Before or after death?(Elsevier Sci Ireland Ltd, 2003) Büken, Bora; Üstündag, N.; Büken, Erhan; Mayda, AS
