Sudebno-Meditsinskaya Ekspertisa最新文献

A historical and medical study of preconditions and circumstances of the forensic anthropology establishment is presented. Official demographic statistics and P.A. Minakov's scientific publication on anthropology and forensic medicine were used. The circumstances of forensic anthropology occurrence (a new scientific direction in forensic medicine) were studied. The precondition of its appearance was a strong migration process, with a prevalent concentration of population in large industrial cities. The fact that studied occurrence took place in Moscow can be explained by the high level of development of the anthropological school at Moscow University, and by the fact that one of its leaders, P.A. Minakov, simultaneously headed the university's department of forensic medicine. The idea of anthropology scientific integration into forensic medicine, which was successfully implemented at the Forensic Medicine Department of the Moscow University, belonged to him.

The study objective is to establish the role of light hepatocytes (Kraevsky cells) for forensic histological diagnosis of glycogen depletion in the liver due to various conditions, including shock. A standard histological examination of liver samples of persons who died from various causes was performed; routine staining with hematoxylin and eosin and additional staining by the PAS method was used. Histotopographic comparison of cross sections was performed to clarify the localization of light hepatocytes with different PAS staining results. It was shown that light hepatocytes have different morphological features, localization, and results of PAS staining, regardless of the cause of death, and are not related to glycogen depletion in them. Light hepatocytes (Kraevski cells) cannot be used as a sign of glycogen depletion and/or shock.

The purpose of the study is a theoretical analysis of the available types of contact traces of blood and the establishment of their occurrence at the objects of medical and forensic examinations. Contact marks are formed as a result of the mechanical interaction of two objects, one of which is stained with blood. The literature data allow us to distinguish several types of contact traces of blood: impressions, smears, smearing, «voids», traces in the form of changes in the existing stain from wiping, washing, traces-artifacts from insects. Each type has a mechanism of formation and characteristic features. We analyzed 107 archival medical and forensic examinations. In the examinations in which the material situation of the scene of the incident (5 or more objects) is maximally represented, contact traces were present in 76% of the examinations, which indicates a high occurrence. The following types of contact traces of blood were the most common: smears (29% of all examinations), smearing (22.4%) and «voids» (10.3%). Other types of contact traces were less common.

The aim of the study: Is to refine the mechanism of major joints' damage formation and qualification criteria of harm degree to the health in articular injuries. The number of patients equal 246, suffered in different circumstances, were examined. Damages of skin and soft tissues in the joints region without affection of internal structures (47%), intraarticular fractures with impaired articular surface congruence (18.0%) and periarticular fractures (15.8%) were the most frequent in non-fatal injuries' outcomes in pedestrians and cyclists suffered from collisions with moving vehicles. Dead pedestrians and cyclists injured in road traffic accidents (RTA) from the side of joints structure had the most frequent the periarticular fractures (6.8%), intraarticular fractures with impaired (14.5%) or intact articular surface congruence (6.5%). Dislocations (45.9%) and dislocation-fracture (54.1%) were common in mechanical injuries. Mostly, work ability was recovered for 1.5-2.0 months in the presence of periarticular fracture, and there was no permanent loss of general work ability. The permanent loss of general work ability exceed 33.0% in case of complicated intraarticular fractures of coxofemoral structures, and in the case of a similar injury of other joints was less than this value. The period of work ability recovery in the case of intraarticular fractures was 2.5-3 months, in the presence of complicated dislocations was from 3 to 6 months. The permanent loss of general work ability did not exceed 30%. The period of work ability recovery in patients with fracture-dislocation varied from 3 to 6 months. The permanent loss of general work ability in this case was from 20% to 60%. The severity of harm to the health was classified as moderate degree in the case of uncomplicated isolated injuries of joints structures, and as moderate or severe degree in the presence of complicated isolated injuries. Bruises of joints' soft tissues were evaluated as mild bodily injury causing a health disorder. Bruises of joints' soft tissues, as well as periarticular and intraarticular fractures in pedestrians and cyclists in the case of RTA are formed when falling on the road surface. Dislocations and fractures-dislocations of humerus and forearm occur as a result of an indirect injury mechanism. Articular injuries of femur are formed under the influence of traumatic force to the femur, exceeding the capability of coxofemoral joint (an indirect injury mechanism). Dislocations and fractures-dislocations in ankle joint are occurred as a result of an indirect injury mechanism and are caused by foot's flexion or rotation with great strength.

The aim of the study: Is to investigate fatal outcomes related to operative interventions in aesthetic plastic surgery for the period from 2010 to 2022 yrs., and to analyze the defects in health care delivery (DHCD), revealed during forensic medical examinations of fatal outcomes. The number of fatal outcomes equal 36, related to operative interventions in aesthetic plastic surgery, was analyzed. The data were collected from the expert's archival opinions (forensic medical examinations of corpse, commission forensic medical examinations based on materials of medical cases and expert opinions), and from judicial acts. The most frequent cause of death (19% of cases) was postoperative development of pulmonary artery thromboembolia, that requires further screening to assess the relationship between denoted reason and type of performed operative intervention as well as the use of anticoagulant therapy. In addition, 19% of the causes of death were related to the toxic lidocaine effects, that shows the necessity of strict control while using anaesthesia during operative interventions. During the forensic medical examination in 55.5% of cases were found the defects in health care delivery (DHCD), with an average of about two DHCD cases. Cause-effect relationship between identified drawbacks of health care delivery and fatal outcome was established in 18 (90%) of the 20 cases. Among them, the DHCD, which are extremely rare in other types of surgical specialty (health care delivery in an inappropriate place and by unqualified persons), were reliably determined in 30% of cases. The necessity of strict control by the relevant competent organizations in health care delivery for plastic surgery specialty, the need for a single system collection of information about fatal cases, associated with operative interventions in aesthetic plastic surgery, and the study of fatality structure and causes in this field were proved. The above mentioned will make it possible to develop unified approaches for the commission forensic medical examinations in this type of cases, and will also contribute to the fatal outcomes' prevention.

An overview of researches, mainly by foreign specialists, on current available approaches for sampling to study the traces of gunshot residue (GSR) is presented. The comparative characteristics of traditional methods of samples (use of cotton and gauze tampons, blotting paper, textile fabrics, adhesive tapes, adhesives and vacuum samplers), as well as advanced technologies, including special devices and sorbents, are given. The characteristics of samplings from hands, scalp, nostrils, clothes of examined persons as well as procedures, that allow to increase the duration of GSR detection, are described in details. The importance of GSR sustainability over time is noted. On average, the most likely detection periods of particles are less than 1 hour for samples, collected from hands, more than 1 hour for samples from clothes and 2-3 hours for face. It is possible to detect the GSR particles in hair up to 24 h., and in nasal mucus after 6 h. of shot. The methods of identification and determination for analytes of inorganic and organic nature are discussed. The most common methods for determining heavy metal particles are atomic spectrometry, namely atomic absorption with electrothermal atomization and atomic emission. The combination of scanning laser ablation and mass-spectrometry with inductively coupled plasma makes it possible to detect more than 15 analytes in a single sample. Scanning electron microscopy with X-ray detectors is effective for the examination of powder particles. The described methods of sampling complement each other increasing the possibility of evidence base for court proceedings.

2 cases of death in males due to multiple head impacts by propeller blades of small vessels are given. The set of the following signs provides a basis for confirming the above-mentioned mechanism and properties of the traumatic object: multiplicity, oblong shape, parallel step-like arrangement of injury lengths, acute-angled M-shaped or Y-shaped injury ends, uneven edges, sometimes with the formation of small flaps and abrasion, lumpy wound walls, multi-fragmented nature of fractures in a limited area of the skullcap and facial skull bones, the location of damage to intracranial structures in the projection of external injuries and fractures of the cerebral skull bones.

The data of the world literature characterizing the forensic aspects of blunt trauma are generalized and systematized. The issues related to the morphology of damage caused after overcoming an obstacle made of various materials by a bullet, the trajectory of a firearm projectile after overcoming an obstacle, the deformation of a bullet, the transfer of fragments of an obstacle by a bullet, the determination of the distance to the target located behind the damaged barrier, the study of the strength properties of individual human armor protection, the nature of the release of particles of an obstacle. The current state of forensic medical examination of blunt trauma is considered, problems and promising directions of their solution are identified. The importance of using knowledge in the field of theoretical mechanics of deformed solid bodies and high-speed impact interaction of solid bodies is noted.

Article is devoted to the problem of production and legal evaluation of repeated commission (complex) forensic medical examinations based on materials of «medical» practices, related to facts of health care delivery adverse outcomes, in criminal and civil proceedings. Reasons of re-examination assignment, theoretical and applied aspects of this procedural institute in evidence in cases of iatrogenic crimes and unqualified health care delivery were considered. The authors pay particular attention to deficiency of legal base and practical approaches to the re-examination assignment and its results' evaluation, and suggest ways to improve the forensic medical and law enforcement activity in this category of cases. The examples from practice, illustrating the content and nature of the re-examination's problem in «medical» cases, were given, the ways to improve the quality of expert work and judicial practice were emphasized, and measures, that will improve the situation in short term, were identified.

The aim of the study: Was to conduct the analysis of patient's clinical observation with acute dinitrophenol poisoning, admitted to a toxicological department of CCH №6 of Izhevsk, Udmurt Republic in 2021 yr. In this clinical case report, a 19 years old girl, who took 20 tablets of dinitrophenol, illegally obtained in online-shop, died. The fatal outcome was realized by the uncoupling of oxidative phosphorylation mechanism and cellular respiration, which in its turn led to serious dystrophic changes in all organs and tissues. Disorders of hemodynamics and blood rheological properties dominated in poisoning pathogenesis, led to congestion, stasis in microcirculatory vessels, hyperpermeability with multiple perivascular hemorrhages in organs, occurrence of piecemeal necrosis in kidneys and liver, nephrosis and nonspecific reactive hepatitis. Production ATP from ADP becomes impossible in these conditions, and respiratory energy chain completely disappears as heat, that explains the heat-increasing and fat-burning effects of dinitrophenol.