Sudebno-Meditsinskaya Ekspertisa最新文献

The study objective is to analyze changes in court practice over a 10-year period (from 2013 to 2022) including the quantitative and qualitative composition of complaints for conducted dental treatment, considering legislative changes in the procedure for the provision of dental service and formalization of the relationship between patient and medical organization. An investigation of 1800 legal cases containing complaints, forensic reports and court decisions allowed to identify tendencies in increasing the number of cases in which patients' demands were fully or partially satisfied, from 54% in 2013-2017 up to 61% in 2018-2022. At the same time, the amounts of payments determined by the courts increased by 14 times. In addition, the percentage of claims against medical organizations providing care under the CHI program increased significantly (from 5% in 2013-2017 to 15% in 2018-2022). A significant impact of changes in normative legal documents regulating the provision of dental care on the qualitative composition of complaints and the issues formed for medical experts by court has been noted.

The article is devoted to legal and forensic medical problems of postmortem donation. The substantive provisions of postmortem donation, as well as normative legal documents regulating the processes of organs harvesting from deceased persons for subsequent transplantation and governing the work of transplantologists and forensic medical experts have been considered. The practical examples illustrating the essence and nature of the problem of postmortem forensic medical expertise of persons with absent organs has been given and the importance of the participation of a forensic medical expert involved in the decision-making process on possibility (or impossibility) of the corpse's organs and tissues explantation without prejudice to the further expert examination has been emphasized. The authors pay particular attention to the inadequacy of the legal framework, including the lack of a clear understanding of the legal status of the person holding the position of forensic medical expert, who provides an expert opinion on the organs' explantation.

Arterial hypertension is a disease that significantly increases the risk of sudden death in different age groups. It is of high scientific interest to study the relationship of arterial hypertension manifestations with different weather conditions. The article provides a review of literature data on the variability of arterial hypertension course depending on meteorological conditions as a risk factor for sudden death.

Objective: Study of 2.6-di(propan-2-yl)phenol (2.6-di(P-2-yl)F) distribution nature in warm-blooded in case of fatal poisoning due to intragastric administration of the substance.

Material and methods: The warm-blooded model consisted of Wistar male rats aged about 4 months, administered 1.800 mg 2.6-di(P-2-yl)F per 1 kg of animal body weight (≈3 LD₅₀). After the rats died, 2.6-di(P-2-yl)F was isolated from their corpses' biomatrices by infusing an ethyl acetate-acetone mixture (7:3), purified by extraction (distribution in the systems trichloromethane-aqueous solution (pH 11.0-11.5) and aqueous solution (pH 2-4) - ethyl acetate), and normal pressure chromatography in a silica gel column L 40×100 µm (eluent hexane-acetone (7:3). The analyte was identified using gas chromatography with mass spectrometry (capillary (0.2 mm) column, stationary phase - polysiloxane with a ratio (in %) of methyl and phenyl substituents of 95:5), thin layer chromatography (Sorbfil plates, dynamic phase hexane-diethyl ether (9:1)), and electronic spectrophotometry (solvent - ethanol). The analyte content was quantified by spectrophotometry.

Results: In the study, 2.6-di(P-2-yl)F mainly accumulated in the stomach contents (378.94±41.51) and tissues (175.20±17.12). Among other biomatrices obtained from poisoned rat corpses, a significant amount of the investigated toxic compound was found in the heart (142.79±13.08) and spleen (117.83±16.23), a bit smaller amounts - in the lungs (112.32±29.54) and small intestine (97.10±11.66).

Conclusions: A scheme for determining 2.6-di(propan-2-yl)phenol in biomaterial has been developed and applied to study the analyte localization in the body of animals poisoned by it. The highest amount of the toxicant (mg/100 g) was found in the stomach contents (378.94±41.51), its tissues (175.20±17.12), heart (142.79±13.08) and spleen (117.83±16.23).

Objective: To examine the changes in dermal mast cells density in the mechanically injured skin and to evaluate the applicability of dermal mast cells density increase as an injuries vitality diagnostic criteria (serial examination, statistically processed results).

Material and methods: 240 skin autopsy samples with mechanical injuries from 40 persons were divided to 3 groups (80 in each group): vital injuries, postmortal injuries, control non-injured samples. A routine histological examination using standard H&E stain and IHC with mast cells tryptase antibodies was performed consequented with histological slides full-format scanning and computer processing.

Results and conclusion: An increase in the density of dermal mast cells relative to control samples was found in 80% of samples with vital injuries and in 50% with postmortem ones. Statistically significant differences in mast cell density were revealed between samples of all 3 groups, but they cannot be used as a reliable vitality diagnostic method.

The study objective was to describe the formation of forensic microbiological examination as an analysis of a new type, defined as the detection and registration of reliably measured environmental and physiological changes within the microbial community of corpse in order to substantiate the possibility of using microbiological parameters to establish the prescription of death coming. It has been determined that the knowledge of the patterns of interaction of a human and his corpse with endogenous and exogenous flora provides the basis for solving a number of traditional and new application-oriented expert tasks and the allocation of such a variety of forensic examination as forensic microbiological examination. Endogenous and exogenous human flora and its interaction with living and dead biological tissues are the objects of this kind of examination, and the dynamic patterns of such interaction are the subject of study. One of the initial relevant tasks of forensic microbiological examination consists in development of methods, adequate for the expert task to be solved, choice of the research «target», «models» for comparative analysis and medium, adequate for task in hand, as well as certification of these methods and standardization of assessment criteria for the obtained results.

Objective: To study emergence mechanism, physical nature, pattern of intravital and postmortem changes of biological and non-biological objects originated in the period from 1550 to 1918 yr. using traditional X-ray and X-ray computed tomography.

Material and methods: The relics of Saint Macarius the Roman of Novgorod, the remains of the First Reverend of the Resurrection Novodevichy Convent in Saint Petersburg Mother Superior Theophania, damages on the chair leg on which Tsesarevich Alexey sat during the shooting of Russian Emperor Nicholas II, his family and entourage in 1918 in Yekaterinburg were stidued.

Results and conclusion: The application of highly informative methods of traditional X-ray and X-ray computed tomography of biological and non-biological objects showed their high informativity and allowed to correctly interpret the emergence mechanism, physical nature, pattern of intravital and postmortem changes of skeleton bones and historical artefact (chair legs) originated long ago. The necessity of special professional training and advanced training of experts in forensic radiology to prevent possible diagnostic and expert errors has been substantiated.

Objective: To examine the applicability of IHC staining method: with TGF-β1 antibodies (serial examination, statistically processed results) and with mast cell tryptase antibodies for injuries vitality determination.

Material and methods: 261 skin autopsy samples with mechanical injuries from 29 persons were divided to 3 groups (87 in each group): vital injuries, postmortal injuries, control non-injured samples. A routine histological examination using standard H&E stain and IHC both with TGF-β1 and mast cells tryptase antibodies was performed.

Results and conclusion: The positive TGF-β1 staining (score 2-3) was found in keratinocytes in vitally injured skin and the negative or weak one (score 0-1) was found in control postmortally injured and non-injured samples. Additionally, dermal TGF-β1 expression was found in some vitally injured skin samples. The difference between vitally injured skin and control samples was statistically significant (p<0.05). No significant difference of dermal mast cells density in groups 1, 2, 3 was found.

Objective: To analyze the contribution of alcohol and drug intoxication to fatal occupational injuries and sudden death at the workplace in Moscow.

Material and methods: A number of death cases of various organizations' employees equal 357 in Moscow in 2023 were investigated. The mean age of the deceased was 48.29±13.9 years, 92.4% of them were men.

Results: Ethanol in blood has been determined in 15% of the deceased. Narcotic drugs and psychotropic medications have been found in 6.7% of cases. Signs of chronic intoxication have been established in 16.5% of the deceased. Chronic intoxication accompanied or aggravated the course of 70% of cardiomyopathies. The proportion of deceased in an accident at an industry or construction site equal 23.9%, as well as ¹/₂ of the deceased in an accident on the street and in a residential building were impaired by alcohol.

Conclusion: The study of the contribution of alcohol and drug consumption to occupational mortality will allow to plan measures for reducing the mortality of working-age population.

One of the main tasks in expertise of living persons is to determine the harm caused to human health. According to the regulations, only harm to human health caused by an injury and causally related with it is taken into account in the forensic examination of a living person. The establishment of a causal link allows to assess correctly the harm severity caused to human health. In this respect, the study of the effect of biological damaging factor on human body (cause) and the result of this interaction (effect) is a new step in modern science. The article presents the analysis of data from the reports of the Russian Reference Center on monitoring of enteric infection agents for 2016-2021; the results of examinations of subjects who suffered from acute enteric infections for 2018-2019 to study causal links in forensic medicine in cases of acute intestinal infections.