Taner Akar

Gazi University, Engüri, Ankara, Turkey

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Publications (15)15 Total impact

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    ABSTRACT: According to World Health Organization, the life expectancy at birth is increasing. An increase in life expectancy might result in increased morbidity and mortality in elderly. The increase in the elderly population also leads to an increase in medico-legal problems, as well. Autopsy is of high importance for determination of cause of death in clinical and forensic cases. The purpose of this study was to find out general characteristics elderly deaths by examining forensic autopsy records. Out of 7033 forensic autopsies performed between years of 2007 and 2011, 1324 were elderly deaths and were included in the scope of the study. The records of public prosecutor office, crime scene investigation and autopsy findings were examined. The majority of victims (70.6%) were male, while 29.4% were female, with a male to female ratio of 2.4/1. Victims’ ages ranged between 65 to 96 years, and the mean age was 74.8 years. A great number of presented elderly deaths were due to unnatural causes, followed by natural deaths cases. Out of unnatural deaths, 63.2% were related to accidents, 23.7% were suicides, and remaining 13.1% were homicides. More than half (56.6%) of all suicidal deaths were due to hanging. Of natural deaths, the majority (82.7%) were due to cardiovascular system disease. In the presented series the cause of death was determined in 90.9% of all elderly deaths, which validates the need for a forensic autopsy. Data obtained through autopsy procedures is of high importance for death statistics.
    Archives of Gerontology and Geriatrics. 01/2014;
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    ABSTRACT: Objective: Tuberculosis (TB) is a disease that arises due to M. tuberculosis complex and usually involves the lungs but can also affect other organs or organ systems. The number of people who died in Turkey was 210146 in 2006 and 0.11% (n=249) of them died because of pulmonary tuberculosis. During autopsy, many microparticles (aerosols) can be generated while taking the organ out of the body, washing the body, or using the oscillating saw. If these aerosols may contain bacilli that can easily infect the health workers. Tuberculin skin test (TST) determines delayed type hypersensitivity reactions to some antigenic components of microorganism. The only sign of latent tuberculosis infection is positive TST. In our study, we aimed to calculate the exposure rate of the autopsy workers to TB bacillus by evaluating TST measurements and chest radiograms. Material and Methods: The study group was composed of 25 physicians and five autopsy technicians. The control group was composed of 30 physicians, residents and specialists of basic medical sciences except of Microbiology. Both groups were evaluated by TST and chest X-rays from TB point of view. We used TST reaction evaluation criteria that was suggested by Ministry of Health of Republic of Turkey while evaluating TST measurements. All measurements were analyzed statistically. Results: TST positivity ratio is determined as 83.3% in the study group and 33.3% in the control group. The mean of TST measurement value is determined as 13.8±4.7 mm in the study group and 8.6±2.2 mm in the control group. There were no statistically significant differences between two groups concerning age, height, marital status, occupational experience or smoking habits (p>0.05). There was a statistically significant difference between study and control groups for the TST values were (F=11.786; p=0.001). There were no statistically significant differences for gender, smoking and interaction between gender-group and smoking-group (p>0.05). Established ANOVA model (univariate ANOVA); explained the =0.903 of TST change and it was statistically significant (F=71.159; p<0.001). There was a statistically significant correlation between TST results and time spent in the autopsy room (r=0.553; p=0.002). Conclusion: Our study shows that autopsy workers have a high risk of TB exposure. We suggest that autopsy workers should be examined for occupational TB exposure. Furthermore, morgue buildings and autopsy rooms of our country should be designed in accordance with the international standards, and measures should be taken in this regard without delay.
    Turkiye Klinikleri Journal of Medical Sciences 11/2010; 30(6):1876-83. · 0.10 Impact Factor
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    ABSTRACT: The serotonin (5-hydroxytryptamine) transporter (5HTt) gene has been reported to be associated with suicidal behavior. In this study, we have investigated the 5' promoter region (i.e., 5HTt gene-linked polymorphic region [5-HTTLPR]) and a 17-base pair variable number of tandem repeats polymorphism in the 5HTt gene for potential association with suicidal behavior in a Turkish population. Genotypes were determined for 182 subjects of suicide (86 attempted suicide and 96 completed suicide) and 181 healthy control subjects. Our results showed that allele frequencies at individual loci were not significantly different in the two groups. This absence of altered individual locus haplotype (allele) frequency suggests the lack of a significant genetic contribution by the 5-HTTLPR or variable number of tandem repeats variations to the expression of suicidal tendencies. However, our linkage disequilibrium analyses indicated that there may be a greater risk for suicidal behavior in carriers of the S10 and L12 alleles of 5-HTTLPR.
    DNA and cell biology 05/2010; 29(8):429-34. · 2.28 Impact Factor
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    ABSTRACT: This study determines the frequency of the spousal domestic violence among 1,178 married women who applied to some first level medical institutions located in Ankara, the capital of Turkey. 77.9% (n = 918) of the women who participated in the study have stated that they have been exposed to at least one of the types of spousal violence during their lifetime. The most reported type of domestic violence suffered by women throughout their lives is economic violence (60.4%). The prevalence of controlling behaviors, emotional violence, physical and sexual violence are 59.6%, 39.7%, 29.9% and 31.3% respectively. KeywordsDomestic violence-Woman-Forensic medicine-Public health-Turkey
    Journal of Family Violence 01/2010; 25(5):449-460. · 1.17 Impact Factor
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    ABSTRACT: Suicide is a global concern, hence, cross-cultural research ought to be central; yet, there is a paucity of cross-cultural study in suicidology. A thematic or theoretical-conceptual analysis of 60 suicide notes drawn from Turkey and the United States, matched for age and sex, was undertaken, based on Leenaars’s empirical-based multidimensional model of suicide. The results suggested that there were more culturally common factors than specific differences; yet, not consistent with previous cross-cultural studies of suicide notes, differences emerged in Turkey notes expressing more indirect and veiled communications (indirect expressions). Specifically, Turkish notes expressed that there may be more reasons to the act than the person writes. It was concluded that the model may be applicable to suicide in both countries, but also much greater cross-cultural study is warranted on specific cultural risk factors. A question raised is whether the findings are related to collectivism versus individualism.
    Journal of Cross-Cultural Psychology 01/2010; 41(2):253-263. · 1.42 Impact Factor
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    ABSTRACT: The aim of this study was to examine the effect of both promoter and intron polymorphisms of the serotonin transporter (5HTT) gene on posttraumatic stress disorder (PTSD) development. For this purpose, two polymorphisms of the 5-HTT gene, which are found in the promoter (5-HTT gene-linked polymorphic region) and second intron (variable number of tandem repeats) of the gene, were analyzed in 100 patients who were admitted to the Emergency Department after a mild physical trauma. None of the 5-HTT polymorphisms studied have an effect on PTSD development after a mild physical injury, but having L allele for 5-HTT gene-linked polymorphic region may cause milder hyperarousal symptoms in those patients who have developed PTSD.
    DNA and cell biology 11/2009; 29(2):71-7. · 2.28 Impact Factor
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    ABSTRACT: The University of Iowa Child Protection Program collaborated with Turkish professionals to develop a training program on child abuse and neglect during 2002-2006 with the goals of increasing professional awareness and number of multidisciplinary teams (MDT), regional collaborations, and assessed cases. This paper summarizes the 5-year outcome. A team of instructors evaluated needs and held training activities in Turkey annually, and provided consultation when needed. Descriptive analysis was done via Excel and SPSS software. Eighteen training activities were held with 3,570 attendees. Over the study period, the number of MDTs increased from 4 to 14. The MDTs got involved in organizing training activities in their institutions and communities. The number of medical curriculum lectures taught by MDTs to medical students/residents, conferences organized by the MDTs, and lectures to non-medical professional audiences increased significantly (R(2)=91.4%, 83.8%, and 69.2%, respectively). The number of abuse cases assessed by the MDTs increased by five times compared to pre-training period. A culturally competent training program had a positive impact on professional attitudes and behaviors toward recognition and management of child abuse and neglect in Turkey. The need to partner with policy makers to revise current law in favor of a greater human services orientation became clear. Pioneers in developing countries may benefit from collaborating with culturally competent instructors from countries with more developed child protection systems to develop training programs so that professional development can improve recognition and management of child abuse and neglect.
    Child abuse & neglect 05/2009; 33(4):247-55. · 2.34 Impact Factor
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    ABSTRACT: The objective of this article was to review the case series' profile followed up by the Gazi University Multidisciplinary Team for Child Protection and to describe the challenges in our child protection system. The cases referred to this team between February 2001 and January 2007 were analyzed. In addition to the clinical management, challenges encountered during follow-up due to gaps in the child protection system were reviewed. A total of 139 patients were referred to the team during the study period. Mean age for physical abuse, sexual abuse, and neglect were 8.9 +/- 6.2, 10.8 +/- 4.2, and 5.1 +/- 5.5 years, respectively. Sexual abuse was significantly less common while neglect was significantly more common in the 0-5 years of age group. In addition to the gaps within each link of the child protection system (medical, legal and social services) in Turkey, interagency collaboration seems to be inadequate. Hospital-based multidisciplinary teams can start such a collaboration.
    The Turkish journal of pediatrics 01/2009; 51(4):336-43. · 0.56 Impact Factor
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    ABSTRACT: Our study was designed to determine whether the hormone and enzyme levels that we have mentioned in serum specimens can be used in postmortem examinations of the cases of hanging or not. Our research includes the postmortem results of the thyroid tissue pathologic examinations, serum levels of triiodothyronine (fT3), thyroxine (fT4), thyrotropin (TSH), thyroglobulin, parathormone (PTH), calcitonin, and amylase in cases of death due to hanging. The mean of fT3 and thyroglobulin levels were higher in hanging cases than those of sudden death cases. This difference was statistically significant (P < 0.05). In our study, we obtained data demonstrating that high postmortem levels of free T3 and thyroglobulin may be indicators of vital reaction in hanging cases. In such cases of death, it seems that applying pressure on the neck region where the thyroid gland is located causes the leakage of thyroglobulin as well as fT3, the active form of the thyroid hormone.
    The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 03/2008; 29(1):49-54. · 0.71 Impact Factor
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    ABSTRACT: There has been limited study of suicide in Islamic countries. This paper marks the first study of suicide notes in Turkey, an Islamic country. Using a classification scheme, 49 suicide notes (a rate of 34.5%) were studied. The results show that note writers do not differ greatly from other suicides. Further analysis of younger (<40) and older (>40) suicide note writers reveal few significant differences. Our results, together with the results of classification studies in different countries, suggest that caution is in order in transposing findings from one country to other countries. Future study of suicide notes should, in fact, focus on cross-cultural investigation.
    Suicide and Life-Threatening Behavior 02/2008; 38(1):122-7. · 1.33 Impact Factor
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    ABSTRACT: Aims: Clinical forensic medicine deals with cases involving both the legal and medical aspects of patient care, such as motor vehicle trauma or poisoning. In this study, we aimed to draw attention to the forensic issues by retrospective investigation of 13823 emergency cases and to share our experiences on this topic. Materials and Methods: This retrospective study was conducted in a university Emergency Department (ED) in Ankara, Turkey. The data were collected from official hospital police sheets. Results: Between 2000 and 2005, 13823 legal cases (3.66% of all ED patients) were examined, and 58.23% of them were male. The mean age was 28.03±16.42 years. The main injury patterns were motor vehicle trauma (43.84%), physical assault (19.04%), suicide attempts (17.10%), and carbon monoxide (CO) poisoning (6.62%). Most of the cases were in the 20-29 years of age group (30.01%). Suicide attempts, CO poisoning and sexual assault victims were mostly female. 46.47% of the cases were admitted to the ED between 16:00 and 23:59. Forensic cases were mostly reported in May (9.92%). Two hundred and forty-two forensic cases died in the ED and 42 died outside the ED previously; 71.53% of them were male. The main cause of death was motor vehicle trauma (62.50%). Conclusions: Emergency physicians will face the challenges of addressing both medical and forensic needs of ED patients.
    Turkish Journal of Medical Sciences 01/2008; 38(6):567-575. · 0.45 Impact Factor
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    Edited by Mahmut ASIRDIZER, Mehmet Sunay YAVUZ, 09/2007; Celal Bayar University.
  • Psychiatric Genetics 05/2006; 16(2):53. · 2.37 Impact Factor
  • Taner Akar, Birol Demirel
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    ABSTRACT: Acil servislerde yada acil müdahale ve tedavi gerektiren hal-lerde hekimlerin Adli Tıp veya Tıp Hukuku alanında düşünme ve araştırma yapma imkanları çok kısıtlıdır. Bu yüzden tüm hekimle-rin özellikle acil durumlarda mesleki uygulamalarını ilgilendiren hukuk ve deontoloji kurallarını ve Adli Tıp konularını çok iyi bil-meleri gerekir (1). Eski Türk Ceza Kanunu'nda, "hayatını tehlikeye maruz kılma" şeklinde yer bulmuş olan hayati tehlike kavramının, yeni Türk Ceza Kanunu'nda artık "yaşamı tehlikeye sokan bir durum" olarak tanımlandığı görülmektedir. Hayati tehlike, etkili eylem sonucu bir şahsın hayatının mutlak surette tehlikeye maruz kalması ancak gerek kendi vücut direnci gerekse yapılan tıbbi müdahaleler sonu-cunda kurtulması durumunda kullanılan bir kavramdır (2). Dolayı-sıyla acil servislerde çalışan hekimlerin hayati tehlike kriterlerini iyi bilmeleri ve hastanın muayene ve tetkikleri tamamlanmadan ve tanısı konmadan hayati tehlike kararını vermekte aceleci dav-ranmamaları gerekmektedir. Çünkü verilen karar olaya neden olan sanığı doğrudan etkilemekte ve kararın doğru verilmediği durum-larda hekim sorumluluğu ortaya çıkmaktadır. Bu çalışmanın amacı; Gazi Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı'na başvuran adli vakaların, evvelce düzenlenen ge-çici adli raporlarında belirtilen hayati tehlike kavramı ile tarafı-mızca verilen kesin raporlarında belirtilen hayati tehlike kavramı arasındaki tutarlılığı araştırmaktır. GEREÇ VE YÖNTEM Gazi Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı'nca 1997-2004 yılları arasında kesin rapor tanzim edilen 540 olgunun, 449'unun (%83.1) geçici adli raporlarına Gazi Üniversitesi Tıp Fakültesi Hastanesi arşivinden ulaşılmış olup olgular retrospek-tif olarak yaş, cinsiyet, olay türü, yaralanma bölgesi, geçici adli raporda ve kesin raporda hayati tehlike mevcudiyeti yönlerinden taranarak analiz edilmiş, geçici adli raporlardaki hayati tehlike mevcudiyeti ile kesin raporlardaki hayati tehlike mevcudiyeti ara-sındaki fark bağımlı gruplarda Ki-Kare (McNemar) analizi ile de-ğerlendirilmiştir. BULGULAR Gazi Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı'na 1997-2004 yılları arasında kesin rapor almak amacı ile başvuran adli olgu sayısı 540'dır. Bu olguların %62.0'ı (335) erkek, %38.0'ı (205) kadındır. En fazla görülen yaş grubu, %25.6 ile (138) 20-29 yaş grubu olup olguların yaş ortalaması 31.88 ± 11.92'dir. Trafik kazaları %71.9 ile (388) adli vakaların başında gelmek-tedir. Bunu %8.0 ile (43) ezici alet yaralanmaları izlemektedir. Yalnızca 2 (%0.4) vakada, birden fazla olay sonucu yaralanma (ateşli silah + ezici alet yaralanması, kesici-delici alet + ezici alet Giriş: Hayati tehlikesi bulunmayan olguların geçici adli raporlarında hayati tehlike varlığı belirtilmesi, olayın sanığının çoğu zaman hürriyetinin kısıtlan-ması gibi ağır hukuki sonuçlara yol açmakta, sonradan verilen kesin raporda hayati tehlikesinin olmadığının belirtilmesi ise hekimlere duyulan güveni sar-sabilmektedir. Amaç: Gazi Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı'na başvuran adli vakaların, evvelce düzenlenen geçici adli raporlarında belirtilen hayati teh-like kavramı ile tarafımızca verilen kesin raporlarında belirtilen hayati tehlike kavramı arasındaki tutarlılığı araştırmaktır. Gereç ve Yöntem: Gazi Üniversitesi Tıp Fakültesi Adli Tıp Anabilim Dalı'nca 1997-2004 yılları arasında kesin rapor tanzim edilen 540 olgunun, 449'unun (%83.1) geçici adli raporlarına Gazi Üniversitesi Tıp Fakültesi Hastanesi arşi-vinden ulaşılmış olup olgular retrospektif olarak yaş, cinsiyet, olay türü, yara-lanma bölgesi, geçici adli raporda ve kesin raporda hayati tehlike mevcudiyeti yönlerinden taranarak analiz edilmiştir. Bulgular: Başvuran adli olguların %62.0'ı (335) erkek, %38.0'ı (205) kadındır. Trafik kazaları %71.9 ile (388) adli vakaların başında gelmektedir. En sık yara-lanan bölge, %57.2 ile (309) baş-boyun bölgesidir. Adli Tıp Uzmanı olmayan hekimlerce düzenlenen, geçici adli raporlarında hayati tehlike varlığı belirtilen olguların %46.6'sının (82) kesin raporlarında hayati tehlikelerinin olmadığı saptanmıştır. Bu fark istatistiksel olarak anlamlı bulunmuştur (p<0.05). Sonuç: Geçici adli raporlarda ve kesin raporlarda belirtilen hayati tehlike kav-ramı arasındaki farklılıkların, Adli Tıp Uzmanı olmayan hekimlerin verecekleri raporları objektif kriterlere dayandırmaları tutumunu kazanmalarıyla ortadan kalkabileceğini düşünmekteyiz. Introduction: In cases in which there is no vital risk, reporting a vital risk in temporary forensic reports leads to severe judicial consequences, such as limi-ting the freedom of the suspect; and reporting no vital risk in definitive reports given later can decrease confidence in the physician.