Sudebno-Meditsinskaya Ekspertisa最新文献

Interest in the topic of age assessment for forensic medical identification of personality has not decreased for over the past decade. Establishing an exact age have a critical importance for law enforcement authorities, for example in case of wrongdoing by illegal migrants without identity documents. The search and systemic analysis of published researches devoted to age assessment by dental status in children and adolescents with subsequent updating of the directions of development in this scientific subject theme and the possibility of their realization in practice in the Russian Federation were carried out in order to have an objective concept of used methods of dental status assessment in the world practice.

Objective: To study the influence of COVID-19, as well as various factors on the rate of deaths caused by suicide.

Material and methods: The statistical analysis of mortality according to the data of «Bureau of FME» in the period from 2019 to 2020 yrs. and the search of scientific publications over the past 10 years in PubMed database have been conducted. Articles describing the factors influencing suicidal deaths in different population groups were selected from the publications.

Results: Statistically significant features that determine the influence of quarantine measures in the period COVID-19 on the mental component of citizens and suicidal dynamics were considered and established.

The article is devoted to the current legal responsibility of medical staff. It is noted that this issue has not been sufficiently studied and requires further research. The article identifies an attempt to assess statistically significant correlation between defects of medical care provision and data of causal analysis as a research task. The practical experience on 215 conclusions of commission forensic medical examinations, in which doctors of surgical specialties were considered on «medical cases», has been summarized. A high statistically significant correlation between defects in treatment, diagnosis, organization of medical care, management of medical records and data of causal relationship has been established on the basis of performed scientific researches. The idea that, despite possible subjectivism, the causal relationship is confirmed by factual data on revealed defects in medical care obtained from the study, has been proven.

Objective: Is to develop a method for determining 2.4-dimethylhydroxybenzene (2.4-DMHOB) in biological material. The analytical methods used in the experiments were extraction, column chromatography of normal pressure, TLC, GC-MS and HPLC. To extract the analyte from the bioactive matrix, maceration with the binary insulating agent acetone-ethyl acetate (3:7) was used, observing the 2:1 mass ratio of the «insulating agent-matrix». Optimal conditions of semi-preparative analyte chromatography were achieved in column (150×10 mm) of «Silasbor» S-18 sorbent in elution with a mixture of acetonitrile-water (7:3), which was used in the proposed cleaning scheme, combining extraction and reversed-phase column chromatography. The application of the mobile phase of tetrachloromethane-dioxane (9.5:0.5) has been substantiated for the selective determination of 2.4-DMHOB by TLC («Sorbfil» plates). The expediency of confirming identification of the analyte in the form of 2.4-dimethyltrymethylsilylphenol using GC-MS (DB-5MS EVIDEX column (25.000×0.2 mm), stationary phase (5%-phenyl)-methylpolysiloxane, carrier gas - helium) has been shown. The group of characteristic particles in the mass spectrum of trimethylsilyl analyte derivative was represented by 45; 59; 73; 82; 91; 105; 119; 135; 149; 163; 179; 194 m/z ions. HPLC (Discovery C18 250×4.6 mm column, eluting liquid - acetate buffer solution with pH 5.5 - acetonitrile, 50:50) was used to confirm the identification and quantification of 2.4-DMHOB. A method for determining 2.4-DMHOB by the HPLC method in biological material (liver tissue) is proposed, which corresponds to the criteria of linearity, selectivity, accuracy, precision and stability. The minimum detectable quantity of 2.4-DMHOB in the bioactive matrix is 0.5 µg/g, the minimum determined quantity is 1.2 ug/g.

Objective: To develop the method of biological fluids' sample processing and mebeverine detection to exclude false results' receiving when diagnosing drug intoxication.

Material and methods: The study was carried out using «Mebeverine» (NJCO «North star», Russia) medicine and hydrolysis by enzymes, namely papain, chymotrypsin, trypsin, chymopsin and hyaluronidase, was applied for sample processing. The extractions were analyzed by methods of HPLC-MS/MS on Nexera XR modular liquid chromatograph with LCMS-8050 (Shimadzu) tandem mass spectrometer and GC-MS on gas chromatograph connected with QP-2020 (Shimadzu, Japanese) mono quadrupole mass spectrometer.

Results and conclusion: It has been revealed that using selective method of sample processing, which consists of aqueous phase extraction at pH=2-4 and enzymatic hydrolysis by papain and hyaluronidase during isolation from blood, is required to detect mebeverine in biological liquids. It has been proven that the native mebeverine is hydrolyzed to veratric (3.4-dimethoxybenzoic) acid and mebeverine alcohol at alkalotic pH value of medium. It has been shown that mebeverine extraction is necessary to study using HPLC-MS/MS, which will allow to avoid the native mebeverine degradation in chromatograph injector as with GC-MS method analysis.

The article presents the experience of artificial intelligence application in research process. The article contains general information about basic concepts of machine learning (clustering and visualization), as well as considers more detaily an experience of clinical testing. The effectiveness of applying Data Analysis methods and means as one of the research stages is demonstrated on the example of a case on processing medical information using algorithms of machine learning: solving the problem on diagnostic value of the proposed indicator (FTF) for determining target age groups. Implementation of such approach of digital transformation improves the operational effectiveness of researches, as well as quality and availability of final technological products being developed - software for solving expert problems.

Objective: To study the sternum ossification processes that take place over time as well as the possibilities of sternum X-rays application to evaluate the age on the modern Russian population in forensic terms.

Material and methods: Sternum X-rays with fragments of ribs' chondral parts were obtained from 369 male and female corpses aged 12-96 years without pathological and traumatic changes. The X-rays were done in frontal projection. The set of examined parameters included: complete and partial synostosis of manubrium and body, induration along the synostosis (or on the articulated edges of manubrium and body), complete and partial synostosis of body segments, traces of body segments union, complete and partial synostosis of body and xiphoid process, induration along the synostosis (or on the articulated edges of manubrium and body), form of costal notches, induration of articular edges of body, presence of calcification foci in sternal edge of II-VII ribs' cartilages, depth of sternum notches, overgrowths on articular edges of body, presence of union between body's costal notches and calcification centers of ribs' cartilages. Mean values, standard deviation and correlation coefficient were determined.

Results: The maximal correlation with age was found in such parameters such: overgrowths on articular edges of body (r=0.6), presence of calcification foci in sternal edge of II-VII ribs (r=0.6), induration of body's articular edges (r=0.5), presence of union between costal notches and calcification centers of ribs cartilages (r=0.5), synostosis of body and xiphoid process (r=0.4).

Conclusion: A subsequent construction of linear model for age diagnosis has its details when comparing the predicted age with the real.

The article presents the results of analysis of doctors' practical training as well as scientific research using organs and tissues of the deceased person. The main problematic aspects preventing appropriate realization of the possibility to use the unclaimed bodies, organs and tissues of the deceased person for these purposes are highlighted based on the study of regulatory framework controlling these activities, scientific publications on defined topic, as well as the direct authors' participation in the training of resident doctors and PhD students.

An expert case is presented in which a man was found dead in his apartment, on the bed. Upon examination of the crime scene, the deceased was found to have a contused wound of the frontoparietal region on the left side. The apartment contained a large number of bloodstains, including patterns characteristic of arterial spurt. The expertise revealed that the head wound has an adjacent rupture of the frontal branch of the left superficial temporal artery. The specified laceration accompanied by stream external hemorrhage was complicated by exsanguination, which was the cause of death. The bloodstain patterns at the scene were analyzed showing that the character of arterial bloodstain patterns is determined by the stage of the streaming ejection, at which its elements come into contact with the receiving surface. At the compact stage, rounded spots are formed; at the atomized stage, an area with numerous small elements resembling a «fine rain» type is observed.

Objective: Development and validation of a sensitive and rapid method for moxonidine detection and quantification in blood and/or urine in clinical toxicology and forensic chemistry.

Material and methods: The method included the following stages: acetonitrile extraction, centrifugation, identification, and quantitative analysis of moxonidine in cadaveric blood and/or urine by high-performance liquid chromatography with a triple quadrupole mass spectrometer.

Results: The method was validated by the following parameters: limit of detection, limit of quantification, linearity, trueness, and precision. Over the entire range of determined concentrations, the relative standard deviation did not exceed 6%.

Conclusion: The obtained results allow future use of this method to detect cases of moxonidine poisoning.