Sudebno-Meditsinskaya Ekspertisa最新文献

The purpose of the study is to determine the importance of primary forensic medical data in the formation of statistical reporting on suicidal mortality using the example of a comparative analysis of hangings encoded as suicides and as injuries with uncertain intentions.

Material and methods: A retrospective analysis of the data on medical death certificates of victims of hangings in the Saratov region for the ten-year period from 2014 to 2023 was carried out.

Results and conclusion: The established dynamics of the progressive increase in hangings encoded as injuries with uncertain intentions (IUI), the uniformity of samples of hangings-suicides and hangings-IUI with a doubtful probability of any other kind of death by hanging, except suicide, allow us to speak about the underestimation of the suicide rate. The reason for this can be considered the established procedure for registering the type of death in primary forensic medical documentation, according to which, in the absence of information about the type of death from law enforcement agencies, the expert is forced to classify these cases into a group of injuries with uncertain intentions, namely, this information is the basis for the formation of statistical reporting on suicidal mortality.

Objective: To detect MUC-1, VEGF-A, SP-D expression in lungs of rats at different times after the administration of baclofen and its combination with ethanol.

Results: An increased MUC-1 expression has been noted in presence of the administration of baclofen and its combination with ethanol. MUC-1 caused an enhancement of VEGF-A expression under hypoxia, that has been also observed in all experimental groups. SP-D expression was increased in all experimental groups.

Conclusions: Understanding of the processes that occur in lungs of animals in administration of baclofen and its combination with ethanol is necessary to develop effective treatment measures for cases of non-fatal poisoning in human by this substance, and it will be useful in determining the immediate cause of death in the case of fatal poisoning.

Objective: To study the electrical conductivity of the knee joints' synovial fluid of human's corpse for assessment of the possibility of its application as criterion of forensic medical diagnosis of postmortem interval.

Material and methods: The work was carried out on practical forensic medical material on the basis of the Bureau of Forensic Medical Expertise in the Republic of Bashkortostan. During the study, 103 corpses of both sexes, different ages who died from various causes were investigated. Synovial fluid of the knee joints from corpses in a state of putrefactive biotransformation of varying degrees of severity was used as the study subject. Measurements of the electrical conductivity value were carried out by conductometry using a calibrated cuvette and AKIP-6109 RLC-meter.

Results: It has been established during the study that low frequencies of electric current of 0.1 and 1 kHz are the most informative for achieving the work objective. Polynomials of the 2nd degree, establishing a relationship between the duration of the postmortem period and the synovial fluid's electrical conductivity value for each frequency of electric current with significance of approximation more than 0.95% at p<0.01, are developed, thar indicates the significance of the presented mathematical models.

Conclusion: It is promising to carry out further research in this direction with obtainment of formulas applicable for the mathematical calculation of the human's postmortem interval.

Results of dissertational researches and scientific researches are traditionally referred to the main sources for improving the quality and level of forensic medical examinations.

Objective: To analyze the results of dissertational researches, completed by degree candidates in the «Forensic Medicine» specialty over a 15-year period (2009-2023), devoted to the analysis of medical errors in cases of improper healthcare delivery.

Material and methods: An analysis of 16 works (4 doctoral and 12 PhD dissertations), published on the official websites of medical universities and the Russian Center of Forensic Medical Expertise, was done. Sampling methods of bibliometric and scientometric analyses were used.

Results: Over a 15-year period, all authors published 379 articles, of which 21 (5.5%) were published in the «Forensic Medical Expertise» journal, 27 (7.1%) - in the «Medical Expertise and Law» journal, the overwhelming majority of articles were published in various medical subject collections, materials of research and practice conferences, congresses, including in 49 peer-reviewed medical journals recommended by the State Commission for Academic Degrees and Titles of the Ministry of Education and Science of the Russian Federation.

Conclusion: Expert panel evidences on the «medical» cases indicate the need to expand and further develop joint scientific studies in such clinical disciplines as: «obstetrics and gynecology», «anesthesiology and resuscitation», «pediatric surgery», «oncology», «neonatology», «cardiology», «dentistry», «maxillofacial surgery», etc.

Frontal collision of a passenger car with a pedestrian in the vertical position can end by throwing the victim's body on the car body without subsequent falling onto the road. In such cases holes on the windscreen and dents on the roof of the compartment are found. Injuries to the lower extremities, head and chest are common for victims. The article describes 3 cases of collision between the car and pedestrian at a speed above 60 km/h. All the victims died at the accident scene. The bodies of two pedestrians were found on the body of vehicles.

Objective: To study the features of visualization and interpretation of significant characteristics of gunshot projectiles and gunshot injuries to non-biological simulators of the human body when performing MSCT with an extended Hounsfield X-ray density scale.

Material and methods: The physical, chemical, forensic and criminalistic characteristics of the firearm projectile and firearm injuries to non-biological imitators of the human body (blocks of sculptural plasticine) were studied. The shots were fired from a smooth-bore long-barreled 12-gauge IZH-58MA hunting rifle using cartridges with solid metal bullets made of lead alloy.

Results and conclusion: The application of the Hounsfield densitometric scale expansion method demonstrated its high information content and allowed to reliably establish the physical and chemical characteristics of a firearm projectile, conduct differential diagnostics of metallic and non-metallic foreign deposits in the area of firearm injuries, and reduce and completely suppress metallic artifacts in the images of the objects under study. It was found that the shift of density windows towards increasing the values of densitometric characteristics in Hounsfield units (HU) led to the formation of image artifacts simulating a bullet shell that did not actually exist. In order to avoid gross expert errors, the identified patterns should be taken into account when establishing the design details of firearms projectiles, when a shell-less (all-metal) firearm projectile can be mistakenly interpreted as a shell-type.

Hyaluronic acid is widely used as an injectable dermal filler in medicine, especially in plastic surgery and cosmetology, due to its biocompatibility and non-immunogenicity. However, these manipulations can cause complications, the most threatening of which is non-thrombotic pulmonary embolism. The article presents a not previously described case of this complication development in a 56-year-old man who underwent penis enlargement with unknown hyaluronic acid-based drug. He complained of general health problems, shortness of breath, sweating, weakness, nausea, tremor in the limbs, and had to seek medical attention on the day of intervention. The patient died next morning. A post-injection damage on the glans penis has been revealed in forensic autopsy, a large accumulation of foreign substance with jelly-like consistency has been found in the area of the root of penis, that was confirmed by histological study. The gel has been also found in the lumina of numerous vessels of the lung of different diameter. Spectrographic analysis established the uniformity of foreign substance from the soft tissues of the root of penis and lung vessels, and also allowed to identify it as hyaluronic acid or hyaluronic acid sodium salt. The objective of this article is to inform a wide forensic audience about the possibility of developing fatal non-thrombotic pulmonary embolism associated with hyaluronic acid injections.

«Sudden infant death syndrome» (SIDS) term unifies cases of non-violent, unexpectedly occurred death of a child under one year of age in the absence of objective data explaining the causes of death, history of disease and postmortem examination.

Objective: To identify the diagnostic criteria allowing to determine the immediate cause of death in SIDS.

Material and methods: We analyzed data on 64 cases of sudden deaths of infants under 1 year of age between 2016 and 2023. All cases of sudden death) were subjected to forensic medical examination arbitrarily for the purpose of excluding violent cause of death (trauma, poisoning). Judicial committee workers requested and preliminarily studied in detail the medical records. Standards of forensic medical examination, established by regulatory order (federal laws and orders) were applied in the corpse's examination. Exclusion group included cases with confirmed chronic or congenital diseases, as well as cases of violent deaths.

Results: The use of an established postmortem examination algorithm and an international standardized autopsy protocol significantly increases the number of identified causes of death, while reducing the frequency of SIDS diagnoses, that in turn allows to improve the quality of health care system work worldwide.

Conclusion: It is necessary to develop and implement analogue of used abroad algorithm in the practice of domestic forensic medical experts and pathologists, that will allow to reveal the most frequent causes of death of children, draw attention of medical staff to them and, as a consequence, improve the quality of life-time diagnosis and contribute to the reduction of infant mortality.

The article presents the results of hyaline cartilage microparticles study by forensic cytology and quantitative enzyme-linked immunosorbent assay. Hyaline cartilage cells' polymorphism was demonstrated as a result of the performed forensic cytological study. The high sensitivity of method was confirmed, the indicators of optic density and total IgG concentration were determined, as well as the optimal values of minimal and maximal calibration samples were identified using enzyme-linked immunosorbent assay. The obtained data can be used by experts of forensic units when determining tissular and species membership of hyaline cartilage microparticles by forensic cytology and enzyme-linked immunosorbent assay methods.

Objective: Implementation of the control method to validate previously obtained calibration functions according to GOST R ISO 11095-2007 using Reference Materials (RM): standard RMs - aqueous solutions of ethanol, produced and certified by the organization, and internal RMs - aqueous solutions of ethanol in different concentrations, developed by the user for internal use.

Material and methods: We applied the control method in accordance with the National Standard of the Russian Federation GOST R ISO 11095-2007 using the standard and internal RMs - aqueous ethanol solutions in different concentrations. Measurements were performed for two subranges of ethanol concentrations on standard and internal RMs in accordance with the certified method.

Results and conclusion: Control charts based on experimental data confirmed that the system was in a controlled state, and the calibration function required no updates on Day 7. No studied values fell outside the upper and lower control limits on the control charts. The uncertainty of the transformed values was assessed during the calibration function validation.